Guadalupe Alonzo

Individual provider Active NPI Athletic Trainer · Banning, CA

NPI 1124523568 · NPPES record last updated Mar 28, 2018

Key facts

NPI
1124523568
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
3800 W Wilson St SPC 255
Banning, CA 92220-3440
Phone
(909) 241-1037
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

3800 W Wilson St SPC 255
Banning, CA 92220-3440

Mailing address

3800 W Wilson St SPC 255
Banning, CA 92220-3440
Phone (909) 241-1037

Other names

  • Lupe Alonzo Other name

Other providers in Banning, CA

All providers in Banning, CA · Athletic Trainer in California

Sources for this page

Verify at the official NPI Registry.