Provider Demographics
NPI:1174111736
Name:ALVAREZ, KAIYA MALANA
Entity type:Individual
Prefix:
First Name:KAIYA
Middle Name:MALANA
Last Name:ALVAREZ
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 1:822 CAMINITO ESTRELLA
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7869
Mailing Address - Country:US
Mailing Address - Phone:619-799-9942
Mailing Address - Fax:
Practice Address - Street 1:822 CAMINITO ESTRELLA
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7869
Practice Address - Country:US
Practice Address - Phone:619-799-9942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1310805376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide