Healthcare Provider Details

I. General information

NPI: 1093156192
Provider Name (Legal Business Name): ALVARO CADENA II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S 11TH ST
SAN JOSE CA
95112-2132
US

IV. Provider business mailing address

201 N K ST
TULARE CA
93274-4005
US

V. Phone/Fax

Practice location:
  • Phone: 408-998-5191
  • Fax:
Mailing address:
  • Phone: 559-687-0929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: