Healthcare Provider Details

I. General information

NPI: 1336060235
Provider Name (Legal Business Name): ALVERNA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 W PICO BLVD APT 301
LOS ANGELES CA
90064-2998
US

IV. Provider business mailing address

2261 MARKET ST STE 70757
SAN FRANCISCO CA
94114-1612
US

V. Phone/Fax

Practice location:
  • Phone: 424-354-1119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL WATKINS
Title or Position: CEO
Credential:
Phone: 424-354-1119