Provider Demographics
NPI:1740726348
Name:ALVARADO, GABRIEL DAVID (CADC1)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:DAVID
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:CADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3026
Mailing Address - Country:US
Mailing Address - Phone:562-454-2534
Mailing Address - Fax:213-537-0880
Practice Address - Street 1:600 E 7TH ST STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1439
Practice Address - Country:US
Practice Address - Phone:213-537-0110
Practice Address - Fax:213-537-0880
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACI5500216101YA0400X
CACII5500216101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)