Provider Demographics
NPI:1851129613
Name:ALEJO, BIANCA DANIELLE DE JESUS (RN)
Entity type:Individual
Prefix:
First Name:BIANCA DANIELLE
Middle Name:DE JESUS
Last Name:ALEJO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 S MARENGO AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3696
Mailing Address - Country:US
Mailing Address - Phone:505-688-4168
Mailing Address - Fax:
Practice Address - Street 1:818 S MARENGO AVE APT 106
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3696
Practice Address - Country:US
Practice Address - Phone:505-688-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95146010163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine