Provider Demographics
NPI:1457538027
Name:ALVAREZ, IRENE (RDHAP)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 BROWNELL ST
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-3013
Mailing Address - Country:US
Mailing Address - Phone:209-658-1007
Mailing Address - Fax:
Practice Address - Street 1:2660 BROWNELL ST
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-3013
Practice Address - Country:US
Practice Address - Phone:209-658-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 176124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist