Basic Information
| Provider Information | |||||||||
| NPI: | 1902022239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES-ALFARO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | SOCORRO | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1880 VALLEY STREET | ||||||||
| Address2: | |||||||||
| City: | ATWATER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097350757 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2115 W. WARDROBE | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093853000 | ||||||||
| FaxNumber: | 2097253941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.