Provider Demographics
NPI:1427148584
Name:PLATA, ALICIA (NP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:PLATA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:500 E ALMOND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5600
Practice Address - Country:US
Practice Address - Phone:559-675-1133
Practice Address - Fax:559-675-0419
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 9450363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology