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General NPI Number Information
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NPI Number | 1124610050
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Entity Type | Individual
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Provider Name | CRISTIAN GENARO ALVARENGA CRUZ
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Gender | Male
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 426 17TH ST STE 200
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City | OAKLAND
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State | CA
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Zip | 94612-2835
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Country | US
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Telephone | 510-433-8600
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Fax | 510-485-7173
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Provider Business Mailing Address
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Address Line | 3511 E 12TH ST UNIT 343
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City | OAKLAND
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State | CA
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Zip | 94601-3474
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Country | US
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Telephone | 510-866-4710
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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