Provider Demographics
NPI:1922580851
Name:MACIAS, ALFRED S
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:S
Last Name:MACIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 ELROVIA AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2151
Mailing Address - Country:US
Mailing Address - Phone:323-494-6225
Mailing Address - Fax:
Practice Address - Street 1:1230 N MARENGO AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-2217
Practice Address - Country:US
Practice Address - Phone:626-797-1124
Practice Address - Fax:626-398-9674
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)