Provider Demographics
NPI:1801038294
Name:ALVARADO-GOMEZ, ROSALINDA (NURSE PRACTIONER)
Entity Type:Individual
Prefix:MRS
First Name:ROSALINDA
Middle Name:
Last Name:ALVARADO-GOMEZ
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 N MISSION RD TRLR 11
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1019
Mailing Address - Country:US
Mailing Address - Phone:323-226-2216
Mailing Address - Fax:
Practice Address - Street 1:1240 N MISSION RD TRLR 11
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1019
Practice Address - Country:US
Practice Address - Phone:323-226-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 264280363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics