Provider Demographics
NPI:1316504707
Name:ALCARAZ, VANESSA E
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:E
Last Name:ALCARAZ
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 1:7470 W WARREN CIR APT 5216
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2809
Mailing Address - Country:US
Mailing Address - Phone:720-987-0652
Mailing Address - Fax:
Practice Address - Street 1:7470 W WARREN CIR APT 5216
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2809
Practice Address - Country:US
Practice Address - Phone:720-987-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
04J901253Z00000X
CO04Z396376J00000X
CO04J901251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemaker