Healthcare Provider Details

I. General information

NPI: 1487565743
Provider Name (Legal Business Name): ADRIANA ELIZARRARAS ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S HARBOR BLVD STE 910
ANAHEIM CA
92805-3721
US

IV. Provider business mailing address

174 W LINCOLN AVE # 112
ANAHEIM CA
92805-2901
US

V. Phone/Fax

Practice location:
  • Phone: 562-821-1491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW141786
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: