Healthcare Provider Details

I. General information

NPI: 1790665255
Provider Name (Legal Business Name): JOSEPH ALATORRE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 E ERICKSON KNOLL LN
EAGLE MOUNTAIN UT
84005-5170
US

IV. Provider business mailing address

1626 E ERICKSON KNOLL LN
EAGLE MOUNTAIN UT
84005-5170
US

V. Phone/Fax

Practice location:
  • Phone: 714-654-3322
  • Fax:
Mailing address:
  • Phone: 714-654-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11587351-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: