Healthcare Provider Details

I. General information

NPI: 1396466504
Provider Name (Legal Business Name): GAUDI ALVARADO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5095
CHULA VISTA CA
91912-5095
US

IV. Provider business mailing address

PO BOX 5095
CHULA VISTA CA
91912-5095
US

V. Phone/Fax

Practice location:
  • Phone: 619-324-8896
  • Fax:
Mailing address:
  • Phone: 619-324-8896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: