Provider Demographics
NPI:1104330745
Name:ALONSO, LIZANDRA
Entity type:Individual
Prefix:
First Name:LIZANDRA
Middle Name:
Last Name:ALONSO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WHEELOCK RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-9719
Mailing Address - Country:US
Mailing Address - Phone:831-768-0941
Mailing Address - Fax:831-762-0971
Practice Address - Street 1:102 WHEELOCK RD
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-9719
Practice Address - Country:US
Practice Address - Phone:831-768-0941
Practice Address - Fax:831-762-0971
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No101Y00000XBehavioral Health & Social Service ProvidersCounselor