MEDICARE: MARIA GUADALUPE ALFARO M.F.T.

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	47737	CA
2	225400000X	Rehabilitation Practitioner	51598	CA

General Provider Information

NPI Number	:	1427181064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA GUADALUPE ALFARO M.F.T.

Provider Business Mailing Address
First Line	:	6931 VAN NUYS BLVD STE 329
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91405-3999
Country	:	US
Telephone Number	:	818-744-7256
Fax Number	:

Provider Business Practice Location Address
First Line	:	6931 VAN NUYS BLVD STE 329
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91405-3999
Country	:	US
Telephone Number	:	818-744-7256
Fax Number	:

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	10/30/2018

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