Healthcare Provider Details

I. General information

NPI: 1730091042
Provider Name (Legal Business Name): ERICA LUANA ALVAREZ N/A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 E HOSPITALITY LN
SAN BERNARDINO CA
92408-3546
US

IV. Provider business mailing address

51895 ADELE AVE
CABAZON CA
92230-4429
US

V. Phone/Fax

Practice location:
  • Phone: 909-891-1599
  • Fax:
Mailing address:
  • Phone: 951-434-8736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: