Provider Demographics
NPI:1750710695
Name:ALVARADO, VICTORIA (LBSW)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 LONGORIA LN
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-9408
Mailing Address - Country:US
Mailing Address - Phone:956-369-4098
Mailing Address - Fax:
Practice Address - Street 1:2715 LONGORIA LN
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-9408
Practice Address - Country:US
Practice Address - Phone:956-369-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58081171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171M00000XMedicaid