Provider Demographics
NPI:1417713975
Name:TELLEZ ARRIAGA, ALVARO (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:
Last Name:TELLEZ ARRIAGA
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881A KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2606
Mailing Address - Country:US
Mailing Address - Phone:209-650-8116
Mailing Address - Fax:
Practice Address - Street 1:201 OLD SAN FRANCISCO RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6385
Practice Address - Country:US
Practice Address - Phone:408-730-4262
Practice Address - Fax:408-523-3224
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95025955363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner