Healthcare Provider Details

I. General information

NPI: 1023936382
Provider Name (Legal Business Name): AMY ALVAREZ - RUBIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18726 S WESTERN AVE STE 120
GARDENA CA
90248-3831
US

IV. Provider business mailing address

617 1/2 W 92ND ST
LOS ANGELES CA
90044-5619
US

V. Phone/Fax

Practice location:
  • Phone: 323-433-4165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: