Provider Demographics
NPI:1386403442
Name:ALIGADA, IRISA CLAIRE (AGPCNP)
Entity type:Individual
Prefix:
First Name:IRISA CLAIRE
Middle Name:
Last Name:ALIGADA
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78804 LA ROSA WAY
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-3814
Mailing Address - Country:US
Mailing Address - Phone:917-977-1548
Mailing Address - Fax:
Practice Address - Street 1:81719 DR CARREON BLVD
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-0600
Practice Address - Country:US
Practice Address - Phone:760-347-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025771363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner