Healthcare Provider Details
I. General information
NPI: 1730892910
Provider Name (Legal Business Name): MICHELE KRISTEN ALVAREZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/03/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1371 E FOXHILL DR APT 165
FRESNO CA
93720-4289
US
IV. Provider business mailing address
PO BOX 8500
COALINGA CA
93210-8500
US
V. Phone/Fax
- Phone: 559-935-4900
- Fax:
- Phone: 559-935-4900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: