Provider Demographics
NPI:1962963140
Name:ALANIZ, IRENE ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:ELIZABETH
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:ELIZABETH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:431 INDIANA ST APT S
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5832
Mailing Address - Country:US
Mailing Address - Phone:818-720-5187
Mailing Address - Fax:
Practice Address - Street 1:852 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1601
Practice Address - Country:US
Practice Address - Phone:917-410-6905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily