Basic Information
| Provider Information | |||||||||
| NPI: | 1588115604 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | PABLO | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | ALVAREZ-ROSAS | ||||||||
| OtherFirstName: | PABLO | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 41 E SAN LUIS ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939013437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316763715 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 601 BAYONET CIR | ||||||||
| Address2: | |||||||||
| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8319200921 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2016 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 104100000X | 85106 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.