Provider Demographics
NPI:1851419220
Name:ASTORGA, ALEJANDRA CRUZ (PA)
Entity Type:Individual
Prefix:MISS
First Name:ALEJANDRA
Middle Name:CRUZ
Last Name:ASTORGA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1826
Mailing Address - Country:US
Mailing Address - Phone:510-350-2777
Mailing Address - Fax:
Practice Address - Street 1:1855 N FAIR OAKS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1620
Practice Address - Country:US
Practice Address - Phone:626-398-6300
Practice Address - Fax:626-398-5948
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17745363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70768FMedicaid
CAHAP70768FMedicaid
CA0050300OtherHEALTHCARE LA
CAEAP70768FMedicaid
CAPA17745OtherLICENSE
CAPA17745OtherLICENSE
CAFHC70768FMedicaid