MEDICARE: STEPHANIE ALVARADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-21-53484	CA

General Provider Information

NPI Number	:	1184132755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ALVARADO

Provider Business Mailing Address
First Line	:	25190 HANCOCK AVE STE C
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-5984
Country	:	US
Telephone Number	:	951-200-5532
Fax Number	:

Provider Business Practice Location Address
First Line	:	25190 HANCOCK AVE STE C
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-5984
Country	:	US
Telephone Number	:	951-200-5532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2018
Last Update Date	:	07/11/2024

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