Provider Demographics
NPI:1508145319
Name:ALVARADO, GUADALUPE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 E PALMDALE BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-5037
Mailing Address - Country:US
Mailing Address - Phone:661-274-8454
Mailing Address - Fax:661-274-7614
Practice Address - Street 1:3166 E PALMDALE BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-5037
Practice Address - Country:US
Practice Address - Phone:661-274-8454
Practice Address - Fax:661-274-7614
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist