Healthcare Provider Details

I. General information

NPI: 1417203720
Provider Name (Legal Business Name): ALVARO RENE CONDE-RODRIGUEZ AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2012
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 39TH ST
RICHMOND CA
94805-2212
US

IV. Provider business mailing address

39428 STRATTON CMN
FREMONT CA
94538-2093
US

V. Phone/Fax

Practice location:
  • Phone: 510-412-5930
  • Fax: 510-412-0567
Mailing address:
  • Phone: 510-565-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: