Provider Demographics
NPI:1871301796
Name:ALONZO, JUAN MIGUEL
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:MIGUEL
Last Name:ALONZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 E KAWEAH AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-3309
Mailing Address - Country:US
Mailing Address - Phone:559-333-2101
Mailing Address - Fax:559-754-2708
Practice Address - Street 1:3107 E KAWEAH AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-3309
Practice Address - Country:US
Practice Address - Phone:559-333-2101
Practice Address - Fax:559-754-2708
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)