Provider Demographics
NPI:1639419377
Name:ALFARO, MARIO FRIEDRICH (RN)
Entity Type:Individual
Prefix:MR
First Name:MARIO
Middle Name:FRIEDRICH
Last Name:ALFARO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 37TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5415
Mailing Address - Country:US
Mailing Address - Phone:719-250-4517
Mailing Address - Fax:
Practice Address - Street 1:1125 37TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5415
Practice Address - Country:US
Practice Address - Phone:719-250-4517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-17
Last Update Date:2013-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA785815163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical