Provider Demographics
NPI:1508630823
Name:MOSQUEDA ALVARADO, ALEJANDRA BEATRIZ
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:BEATRIZ
Last Name:MOSQUEDA ALVARADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:ALEJANDRA
Other - Last Name:MOSQUEDA ALVARADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1172 PASEO DE SU MAJESTAD
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-3311
Mailing Address - Country:US
Mailing Address - Phone:442-270-6558
Mailing Address - Fax:
Practice Address - Street 1:1172 PASEO DE SU MAJESTAD
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-3311
Practice Address - Country:US
Practice Address - Phone:442-270-6558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty