Healthcare Provider Details

I. General information

NPI: 1629667985
Provider Name (Legal Business Name): VERONICA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 N BROOKHURST ST STE 200
ANAHEIM CA
92801-5229
US

IV. Provider business mailing address

10832 VAN RUITEN ST
NORWALK CA
90650-3548
US

V. Phone/Fax

Practice location:
  • Phone: 714-780-0750
  • Fax: 714-780-0757
Mailing address:
  • Phone: 562-716-1595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: