Individual provider · NPI-1

Alexxis Viridianna Acosta

Student in an Organized Health Care Education/Training Program · Riverside, CA

NPI number1043673874

StatusActive

Last updated in NPPESApr 14, 2021

Details

NPI: 1043673874
Entity type: Individual (NPI-1)
Name: Alexxis Viridianna Acosta
Sex: Female
Sole proprietor: Yes
Enumeration date: Mar 30, 2016
Certification date: Apr 14, 2021
Last updated: Apr 14, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
390200000X	Student in an Organized Health Care Education/Training Program	–	–	Yes
225400000X	Rehabilitation Practitioner	–	–

Practice location

6700 Indiana Ave
Riverside, CA 92506-4290

Phone 909-599-1227

Mailing address

6700 Indiana Ave
Riverside, CA 92506-4290

Other practice locations

6971 Bandini Blvd
Commerce, CA 90040-3329

Phone 323-888-9496 · Fax 323-888-0682

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