Provider Demographics
NPI:1346604659
Name:ALVIZO, SALUDAINE
Entity type:Individual
Prefix:
First Name:SALUDAINE
Middle Name:
Last Name:ALVIZO
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 1:1831 W RANDOM DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-2664
Mailing Address - Country:US
Mailing Address - Phone:714-651-2482
Mailing Address - Fax:
Practice Address - Street 1:1831 W RANDOM DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-2664
Practice Address - Country:US
Practice Address - Phone:714-651-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47-3720189374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide