Basic Information
| Provider Information | |||||||||
| NPI: | 1265557409 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVARADO | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 438 N WHITE RD | ||||||||
| Address2: | MOMENTUM FOR MENTAL HEALTH | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951271439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082546848 | ||||||||
| FaxNumber: | 4082549960 | ||||||||
| Practice Location | |||||||||
| Address1: | 185 MARTINVALE LN | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082070070 | ||||||||
| FaxNumber: | 4082070075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 104100000X | ASW69512 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.