Healthcare Provider Details

I. General information

NPI: 1659051530
Provider Name (Legal Business Name): ALVARADO FAMILY COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 01/14/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12223 HIGHLAND AVE STE 106-228
RANCHO CUCAMONGA CA
91739-2574
US

IV. Provider business mailing address

12223 HIGHLAND AVE STE 106-228
RANCHO CUCAMONGA CA
91739-2574
US

V. Phone/Fax

Practice location:
  • Phone: 909-344-7352
  • Fax:
Mailing address:
  • Phone: 909-344-7352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA MARIE ALVARADO
Title or Position: CEO & PRESIDENT
Credential: LMFT
Phone: 909-344-7352