Basic Information
Provider Information
NPI: 1487286142
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVAREZ-PADILLA
FirstName: NORA
MiddleName: CECILIA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22445 ALESSANDRO BLVD STE 113-114
Address2:  
City: MORENO VALLEY
State: CA
PostalCode: 925538358
CountryCode: US
TelephoneNumber: 9519249791
FaxNumber: 9519249754
Practice Location
Address1: 22445 ALESSANDRO BLVD STE 113-114
Address2:  
City: MORENO VALLEY
State: CA
PostalCode: 925538358
CountryCode: US
TelephoneNumber: 9519249791
FaxNumber: 9519249754
Other Information
ProviderEnumerationDate: 02/10/2020
LastUpdateDate: 10/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XAPCC7289CAY Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500X  N Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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