Provider Demographics
NPI:1396227518
Name:ALFARO, VERONICA (BA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ALFARO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARTIN LUTHER KING JR BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-3536
Mailing Address - Country:US
Mailing Address - Phone:323-249-2950
Mailing Address - Fax:310-609-0301
Practice Address - Street 1:3737 MARTIN LUTHER KING JR BLVD STE 550
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3536
Practice Address - Country:US
Practice Address - Phone:323-249-2950
Practice Address - Fax:310-609-0301
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator