Provider Demographics
NPI:1669220232
Name:PORCELLA, ALESSANDRO JR (ND)
Entity type:Individual
Prefix:DR
First Name:ALESSANDRO
Middle Name:
Last Name:PORCELLA
Suffix:JR
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E PALOMAR ST # C233
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6976
Mailing Address - Country:US
Mailing Address - Phone:619-796-4777
Mailing Address - Fax:
Practice Address - Street 1:601 E PALOMAR ST # C233
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6976
Practice Address - Country:US
Practice Address - Phone:619-796-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1495175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath