Healthcare Provider Details

I. General information

NPI: 1275492415
Provider Name (Legal Business Name): ALVINA MUSHFIQUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12459 LEWIS ST STE 201
GARDEN GROVE CA
92840-6606
US

IV. Provider business mailing address

2733 EAST 12TH STREET, MAILBOX C2 SUITE 220
BROOKLYN NY
11235-4672
US

V. Phone/Fax

Practice location:
  • Phone: 800-249-1266
  • Fax:
Mailing address:
  • Phone: 800-249-1266
  • Fax: 888-588-2752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: