Healthcare Provider Details

I. General information

NPI: 1760230981
Provider Name (Legal Business Name): RONALD ALVARADO A.S.,CADC II/ICADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26010 MCCALL BLVD STE H
MENIFEE CA
92586-1983
US

IV. Provider business mailing address

7344 MAGNOLIA AVE
RIVERSIDE CA
92504-3819
US

V. Phone/Fax

Practice location:
  • Phone: 951-722-2759
  • Fax:
Mailing address:
  • Phone: 310-496-9716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number24-CCHW-00011
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA063000723
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number24-CCHW-00011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: