Provider Demographics
NPI:1700212321
Name:ALVAREZ, DENISE YADIRA
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:YADIRA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 BEYER BLVD
Mailing Address - Street 2:SUITE B-103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-3499
Mailing Address - Country:US
Mailing Address - Phone:619-690-9904
Mailing Address - Fax:619-690-9942
Practice Address - Street 1:3065 BEYER BLVD
Practice Address - Street 2:SUITE B-103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-3499
Practice Address - Country:US
Practice Address - Phone:619-690-9904
Practice Address - Fax:619-690-9942
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)