Provider Demographics
NPI:1538827720
Name:ALVAREZ, DANA L
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3523
Mailing Address - Country:US
Mailing Address - Phone:951-358-5751
Mailing Address - Fax:951-358-4797
Practice Address - Street 1:3933 HARRISON ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3523
Practice Address - Country:US
Practice Address - Phone:951-358-5751
Practice Address - Fax:951-358-4797
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN226189164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse