Provider Demographics
NPI:1760121016
Name:ALVAREZ, GUADALUPE
Entity Type:Individual
Prefix:MS
First Name:GUADALUPE
Middle Name:
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 1:526 W INDIAN SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-2009
Mailing Address - Country:US
Mailing Address - Phone:951-423-9108
Mailing Address - Fax:
Practice Address - Street 1:526 W INDIAN SCHOOL LN
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-2009
Practice Address - Country:US
Practice Address - Phone:951-423-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst