Provider Demographics
NPI:1396596722
Name:ALVARADO, JENNIFER PAOLA
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAOLA
Last Name:ALVARADO
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 1:2112 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-2742
Mailing Address - Country:US
Mailing Address - Phone:650-797-9049
Mailing Address - Fax:
Practice Address - Street 1:44093 S GRIMMER BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6382
Practice Address - Country:US
Practice Address - Phone:510-284-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider