Provider Demographics
NPI:1245441757
Name:ALVAREZ-HERNANDEZ, BLANCA ADRIANA (MFC52422)
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:ADRIANA
Last Name:ALVAREZ-HERNANDEZ
Suffix:
Gender:F
Credentials:MFC52422
Other - Prefix:MRS
Other - First Name:BLANCA
Other - Middle Name:ADRIANA
Other - Last Name:ALVAREZ-HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:5100 N. 6TH ST. 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5243
Mailing Address - Country:US
Mailing Address - Phone:559-301-0990
Mailing Address - Fax:559-224-4990
Practice Address - Street 1:1574 S. LIND AVE.
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1425
Practice Address - Country:US
Practice Address - Phone:559-301-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA52422106H00000X
CAMFC 52422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XOtherMEDICAL- FRESNO COUNTY