MEDICARE: ALEJANDRA PRIETO DE CHAVEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		CA
2	163W00000X	Registered Nurse	95184911	CA

General Provider Information

NPI Number	:	1164381448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA PRIETO DE CHAVEZ

Provider Business Mailing Address
First Line	:	607 SNOW CREEK DR
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-8762
Country	:	US
Telephone Number	:	209-988-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 E COTATI AVE
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-3609
Country	:	US
Telephone Number	:	707-664-2880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “ ALEJANDRA PRIETO DE CHAVEZ ” Practice Location

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