Provider Demographics
NPI:1386217081
Name:ALVAREZ, MINDY (RN)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:ALVAREZ
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 1:7405 CORRESPONDENCE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8274
Mailing Address - Country:US
Mailing Address - Phone:909-815-3190
Mailing Address - Fax:
Practice Address - Street 1:7405 CORRESPONDENCE DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8274
Practice Address - Country:US
Practice Address - Phone:909-815-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95252151163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse