Provider Demographics
NPI:1457810061
Name:ALAVANZA, LUMINITA DOINA (AGNP)
Entity Type:Individual
Prefix:
First Name:LUMINITA
Middle Name:DOINA
Last Name:ALAVANZA
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 S MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3132
Mailing Address - Country:US
Mailing Address - Phone:909-809-1663
Mailing Address - Fax:
Practice Address - Street 1:1307 W 6TH ST STE 105
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1644
Practice Address - Country:US
Practice Address - Phone:888-873-6220
Practice Address - Fax:888-873-6220
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA791574163WP0808X
CANP95011090363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care