Healthcare Provider Details

I. General information

NPI: 1558544064
Provider Name (Legal Business Name): DANIEL ALVILLAR M.S.W., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 N WILMINGTON AVE
COMPTON CA
90222
US

IV. Provider business mailing address

2313 CARROLL PARK S
LONG BEACH CA
90814-2230
US

V. Phone/Fax

Practice location:
  • Phone: 323-541-1411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW65481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: