Provider Demographics
NPI:1174294300
Name:ALCAZAR ALVAREZ, BEATRIZ (LICSW)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:ALCAZAR ALVAREZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12827 CARRIZO PLAIN WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742
Mailing Address - Country:US
Mailing Address - Phone:707-393-8675
Mailing Address - Fax:
Practice Address - Street 1:12827 CARRIZO PLAIN WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742
Practice Address - Country:US
Practice Address - Phone:707-393-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN257981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical