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NPI Code Detail

MEDICARE: GUADALUPE ANTAZO ALVAREZ LCSW

MEDICARE: GUADALUPE ANTAZO ALVAREZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS23252CA

General Provider Information

NPI Number : 1023174828
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUADALUPE ANTAZO ALVAREZ LCSW
Provider Business Mailing Address
First Line : 333 S BEAUDRY AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1466
Country : US
Telephone Number : 213-241-3305
Fax Number :
Provider Business Practice Location Address
First Line : 333 S BEAUDRY AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1466
Country : US
Telephone Number : 213-241-3841
Fax Number : 213-241-3305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 03/17/2018

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Directions to “ GUADALUPE ANTAZO ALVAREZ LCSW” Practice Location

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