Provider Demographics
NPI:1205377009
Name:ALVARENGA, ALICIA MERCEDES (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MERCEDES
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 WALPERT ST
Mailing Address - Street 2:APT 89
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-6754
Mailing Address - Country:US
Mailing Address - Phone:510-600-3347
Mailing Address - Fax:
Practice Address - Street 1:20579 SANTA MARIA AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5610
Practice Address - Country:US
Practice Address - Phone:510-600-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor