Provider Demographics
NPI:1245846328
Name:TOVAR-ALVARADO, MARIA A (AMFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:TOVAR-ALVARADO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51568 LA PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-3709
Mailing Address - Country:US
Mailing Address - Phone:760-296-5520
Mailing Address - Fax:
Practice Address - Street 1:1612 1ST ST
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1407
Practice Address - Country:US
Practice Address - Phone:760-398-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT122745106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAMFT122745OtherASSOCIATE MARRIAGE AND FAMILY THERAPIST
CAAPCC8550OtherASSOCIATE PROFESSIONAL CLINICAL COUNSELOR