MEDICARE: ALEJANDRA ALVAREZ LPCCA

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	106H00000X	Marriage & Family Therapist	LPCCA1917	CA

General Provider Information

NPI Number	:	1306324116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA ALVAREZ LPCCA

Provider Business Mailing Address
First Line	:	PO BOX 6753
Second Line	:
City	:	LA QUINTA
State	:	CA
Zip	:	92248-6753
Country	:	US
Telephone Number	:	760-777-7720
Fax Number	:	760-452-8532

Provider Business Practice Location Address
First Line	:	43585 MONTEREY AVE STE 1
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-9398
Country	:	US
Telephone Number	:	760-777-7720
Fax Number	:	760-452-8532

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

Provider Enumeration Date	:	08/02/2018
Last Update Date	:	08/02/2018

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