MEDICARE: RONALDO VICTORIANO ALONZO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	172V00000X	Community Health Worker
2	104100000X	Social Worker
3	101Y00000X	Counselor
4	171M00000X	Case Manager/Care Coordinator	CA
5	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1902111263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALDO VICTORIANO ALONZO

Provider Business Mailing Address
First Line	:	4411 E CESAR CHAVEZ BLVD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3604
Country	:	US
Telephone Number	:	559-453-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 N MILLBROOK AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-1425
Country	:	US
Telephone Number	:	559-453-1008
Fax Number	:

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

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	05/26/2026

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