Provider Demographics
NPI:1750578142
Name:ALVARADO, DONNA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22926 CERCA DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-2301
Mailing Address - Country:US
Mailing Address - Phone:661-645-0978
Mailing Address - Fax:661-296-1624
Practice Address - Street 1:25000 AVENUE STANFORD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4553
Practice Address - Country:US
Practice Address - Phone:661-645-0978
Practice Address - Fax:661-296-1624
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12558103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11397532OtherCAQH