Healthcare Provider Details

I. General information

NPI: 1114051182
Provider Name (Legal Business Name): ELAINE ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 W HERNDON AVE SUITE 300
FRESNO CA
93711-0552
US

IV. Provider business mailing address

1470 W HERNDON AVE SUITE 300
FRESNO CA
93711-0552
US

V. Phone/Fax

Practice location:
  • Phone: 559-256-2000
  • Fax: 559-256-3000
Mailing address:
  • Phone: 559-256-2000
  • Fax: 559-256-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: