Healthcare Provider Details

I. General information

NPI: 1881466977
Provider Name (Legal Business Name): ELIZABETH ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9412 BIG HORN BLVD STE 6
ELK GROVE CA
95758-1101
US

IV. Provider business mailing address

3349 STARBURST WALK
SACRAMENTO CA
95834-2141
US

V. Phone/Fax

Practice location:
  • Phone: 916-226-2812
  • Fax:
Mailing address:
  • Phone: 916-835-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18579
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: