Provider Demographics
NPI:1821602160
Name:ALVARADO, KLARISSA ALICIA (RBT)
Entity Type:Individual
Prefix:
First Name:KLARISSA
Middle Name:ALICIA
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 DEANNE ST
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-2817
Mailing Address - Country:US
Mailing Address - Phone:530-845-8468
Mailing Address - Fax:
Practice Address - Street 1:877 EMBARCADERO DR STE 1
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-1400
Practice Address - Country:US
Practice Address - Phone:916-693-6469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician