MEDICARE: ALICIA VALLEJO DEANDA CHW

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	172V00000X	Community Health Worker	A39805	CA

General Provider Information

NPI Number	:	1740141613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA VALLEJO DEANDA CHW

Provider Business Mailing Address
First Line	:	4990 ARLINGTON AVE STE D
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2757
Country	:	US
Telephone Number	:	951-785-9011
Fax Number	:	951-785-1436

Provider Business Practice Location Address
First Line	:	4990 ARLINGTON AVE STE D
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2757
Country	:	US
Telephone Number	:	951-785-9011
Fax Number	:	951-785-1436

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

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	12/04/2025

Similar Medicare Providers

1881657468 — HA THI NGOC LE M.D.
Practice Location Address:

4990 ARLINGTON AVE , SUITE D
RIVERSIDE, CA
92504-2757

Practice Phone: 909-881-7320
Practice Fax: 909-881-7330

1952351686 — SAN MARCOS MEDICAL GROUP INC.
Practice Location Address:

4990 ARLINGTON AVE
RIVERSIDE, CA
92504-2757

Practice Phone: 951-785-9011
Practice Fax: 951-785-9011

1225255185 — DR. REYNALDO RAYMUNDO ABEJUELA M.D.
Practice Location Address:

4990 ARLINGTON AVE
RIVERSIDE, CA
92504-2757

Practice Phone: 951-343-3150
Practice Fax:

1659589489 — MRS. CHRISTINE JOY PHONGDARA N.P.
Practice Location Address:

4990 ARLINGTON AVE STE D
RIVERSIDE, CA
92504-2757

Practice Phone: 951-785-9011
Practice Fax:

1386802585 — DR. JULIET KAREN SUTHERLAND M.D.
Practice Location Address:

4990 ARLINGTON AVE , SUITE G
RIVERSIDE, CA
92504-2757

Practice Phone: 951-343-3151
Practice Fax: 951-343-3155

1902299191 — LAURA KAI QUAYE NP
Practice Location Address:

4990 ARLINGTON AVE , SUITE D
RIVERSIDE, CA
92504-2757

Practice Phone: 951-785-9011
Practice Fax:

Directions to “ ALICIA VALLEJO DEANDA CHW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.