Provider Demographics
NPI:1720272792
Name:ALVARADO, LETICIA (BS, MS, MSW)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:BS, MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 480652
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-9252
Mailing Address - Country:US
Mailing Address - Phone:323-646-2930
Mailing Address - Fax:
Practice Address - Street 1:1342 S BONNIE BRAE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5403
Practice Address - Country:US
Practice Address - Phone:213-351-5909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor