Basic Information
| Provider Information | |||||||||
| NPI: | 1114317120 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GALLEGOS | ||||||||
| FirstName: | ALEJANDRA | ||||||||
| MiddleName: | NINETH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14300 CLINTON ST SPC 174 | ||||||||
| Address2: | |||||||||
| City: | GARDEN GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928434546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146046656 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927012304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884999303 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2015 | ||||||||
| LastUpdateDate: | 01/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174H00000X | Y | Other Service Providers | Health Educator |
No ID Information.