Healthcare Provider Details

I. General information

NPI: 1881364891
Provider Name (Legal Business Name): CORINA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 N CENTRAL AVE STE 460
PHOENIX AZ
85012-1995
US

IV. Provider business mailing address

PO BOX 541
CLIFTON AZ
85533-0541
US

V. Phone/Fax

Practice location:
  • Phone: 646-450-7748
  • Fax:
Mailing address:
  • Phone: 623-224-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-12813
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: