Provider Demographics
NPI:1609103043
Name:ALVAREZ, ENELIDA (LCSW)
Entity Type:Individual
Prefix:
First Name:ENELIDA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 W 145TH ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-1431
Mailing Address - Country:US
Mailing Address - Phone:310-560-6441
Mailing Address - Fax:
Practice Address - Street 1:1612 W 145TH ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-1431
Practice Address - Country:US
Practice Address - Phone:310-560-6441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW740171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical