Provider Demographics
NPI:1902011091
Name:ALVAREZ, MONA
Entity Type:Individual
Prefix:
First Name:MONA
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 1:1137 W. 6TH ST.
Mailing Address - Street 2:
Mailing Address - City:LOAS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1137 W. 6TH ST.
Practice Address - Street 2:
Practice Address - City:LOAS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017
Practice Address - Country:US
Practice Address - Phone:213-250-1005
Practice Address - Fax:213-250-1006
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)