Provider Demographics
NPI:1346014057
Name:AGUILERA ALVAREZ, ADRIANA (CHW)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:AGUILERA ALVAREZ
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8016 GRACE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-2830
Mailing Address - Country:US
Mailing Address - Phone:909-545-7954
Mailing Address - Fax:
Practice Address - Street 1:8016 GRACE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-2830
Practice Address - Country:US
Practice Address - Phone:909-545-7954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker