Provider Demographics
NPI:1891399481
Name:ALVAREZ, BRANDON ULYSSES
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:ULYSSES
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:B
Other - Middle Name:ULYSSES
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:668 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2960
Mailing Address - Country:US
Mailing Address - Phone:419-470-9248
Mailing Address - Fax:
Practice Address - Street 1:3450 3RD STREET
Practice Address - Street 2:BLDG 1, UNIT 1C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124
Practice Address - Country:US
Practice Address - Phone:415-437-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator