Provider Demographics
NPI:1922748946
Name:ALVARADO, JOHANA ELIZABETH
Entity type:Individual
Prefix:
First Name:JOHANA
Middle Name:ELIZABETH
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 1:2560 N PERRIS BLVD STE N-I
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-3254
Mailing Address - Country:US
Mailing Address - Phone:951-315-4124
Mailing Address - Fax:
Practice Address - Street 1:2560 N PERRIS BLVD STE N-I
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-3254
Practice Address - Country:US
Practice Address - Phone:951-315-4124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSSUDBLOC175T00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist