Basic Information
| Provider Information | |||||||||
| NPI: | 1588212807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | DANIELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 935 E CAMBRIDGE AVE | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932925521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598270113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 520 E TULARE AVE | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932923629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596230900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2019 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1041C0700X | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.