Basic Information
Provider Information
NPI: 1720417934
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVARADO
FirstName: DAVID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 W CARSON ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905022004
CountryCode: US
TelephoneNumber: 2137600653
FaxNumber: 3103287217
Practice Location
Address1: 1000 W CARSON ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905022004
CountryCode: US
TelephoneNumber: 3102221604
FaxNumber: 3103287217
Other Information
ProviderEnumerationDate: 11/07/2013
LastUpdateDate: 03/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
104100000X  N Behavioral Health & Social Service ProvidersSocial Worker 
171M00000X  N Other Service ProvidersCase Manager/Care Coordinator 
1041C0700X106424CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home