Provider Demographics
NPI:1912691940
Name:SORIA ARELLANO, ALEJANDRINA
Entity Type:Individual
Prefix:
First Name:ALEJANDRINA
Middle Name:
Last Name:SORIA ARELLANO
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 1:701 BROOKSTONE RD UNIT 203
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-2354
Mailing Address - Country:US
Mailing Address - Phone:619-396-9859
Mailing Address - Fax:
Practice Address - Street 1:821 KUHN DR STE 101
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4508
Practice Address - Country:US
Practice Address - Phone:619-396-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69966225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist