Provider Demographics
NPI:1740849439
Name:ALCOMENDRAS, ELISE NERIA
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:NERIA
Last Name:ALCOMENDRAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34350 ENEA TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-3018
Mailing Address - Country:US
Mailing Address - Phone:510-396-8522
Mailing Address - Fax:
Practice Address - Street 1:34350 ENEA TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3018
Practice Address - Country:US
Practice Address - Phone:510-396-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator