Provider Demographics
NPI:1043777337
Name:ALEJANDRE, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:ALEJANDRE
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 1:3801 EVALEE LN
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-4230
Mailing Address - Country:US
Mailing Address - Phone:209-417-8857
Mailing Address - Fax:
Practice Address - Street 1:3801 EVALEE LN
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4230
Practice Address - Country:US
Practice Address - Phone:209-417-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN701789164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse