Provider Demographics
NPI:1225924160
Name:ALVAREZ, TAMMY M (PTA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19848 MERRIDY ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3525
Mailing Address - Country:US
Mailing Address - Phone:310-628-7557
Mailing Address - Fax:
Practice Address - Street 1:6740 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5179
Practice Address - Country:US
Practice Address - Phone:818-708-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49810225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant