Provider Demographics
NPI:1073068359
Name:ALVAREZ, PAOLA ELIANA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ELIANA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 PUGET SOUND WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1533
Mailing Address - Country:US
Mailing Address - Phone:408-332-2348
Mailing Address - Fax:
Practice Address - Street 1:874 PUGET SOUND WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1533
Practice Address - Country:US
Practice Address - Phone:408-332-2348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP20595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist