Provider Demographics
NPI:1407461148
Name:ALVAREZ, HARRIET (CAMTC)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:CAMTC
Other - Prefix:
Other - First Name:MAGENTA
Other - Middle Name:
Other - Last Name:GREENWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:88 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3076
Mailing Address - Country:US
Mailing Address - Phone:707-228-7775
Mailing Address - Fax:
Practice Address - Street 1:88 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3076
Practice Address - Country:US
Practice Address - Phone:707-228-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7029224163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7029224OtherMASSAGE