Healthcare Provider Details

I. General information

NPI: 1235920174
Provider Name (Legal Business Name): GUADALUPE CARRANZA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E UNION AVE APT 622
LAS CRUCES NM
88001-7460
US

IV. Provider business mailing address

320 E UNION AVE APT 622
LAS CRUCES NM
88001-7460
US

V. Phone/Fax

Practice location:
  • Phone: 480-738-2736
  • Fax:
Mailing address:
  • Phone: 480-738-2736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: