Provider Demographics
NPI:1508350448
Name:HIDALGO, JANETH ALEJANDRA
Entity Type:Individual
Prefix:
First Name:JANETH
Middle Name:ALEJANDRA
Last Name:HIDALGO
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 1:3765 VIA ESPANA
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4547
Mailing Address - Country:US
Mailing Address - Phone:951-235-5629
Mailing Address - Fax:
Practice Address - Street 1:3765 VIA ESPANA
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4547
Practice Address - Country:US
Practice Address - Phone:951-235-5629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program