Basic Information
| Provider Information | |||||||||
| NPI: | 1285702266 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | RAUL | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MCW II | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6330 RUGBY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902556938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238266300 | ||||||||
| FaxNumber: | 3232777862 | ||||||||
| Practice Location | |||||||||
| Address1: | 6330 RUGBY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902556938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238266300 | ||||||||
| FaxNumber: | 3232777862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 06/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.