Provider Demographics
NPI:1821656919
Name:ALVAREZ, YAJAIRA B I
Entity type:Individual
Prefix:
First Name:YAJAIRA
Middle Name:B
Last Name:ALVAREZ
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 TAPO ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-0467
Mailing Address - Country:US
Mailing Address - Phone:559-212-5984
Mailing Address - Fax:
Practice Address - Street 1:2775 TAPO ST STE 102
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-0467
Practice Address - Country:US
Practice Address - Phone:053-295-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 106H00000X
CALMFT147038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist