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NPI Code Detail

MEDICARE: MS. ALEXIS RENEE TOVAR MSW, LCSW

MEDICARE: MS. ALEXIS RENEE TOVAR MSW, 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 Worker74152CA

General Provider Information

NPI Number : 1063722031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALEXIS RENEE TOVAR MSW, LCSW
Provider Business Mailing Address
First Line : 3801 MIRANDA AVE # 122
Second Line :
City : PALO ALTO
State : CA
Zip : 94304-1290
Country : US
Telephone Number : 831-884-1035
Fax Number : 831-884-1033
Provider Business Practice Location Address
First Line : 201 9TH ST # MONT-122
Second Line :
City : MARINA
State : CA
Zip : 93933-6039
Country : US
Telephone Number : 831-884-1035
Fax Number : 831-884-1033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2010
Last Update Date : 04/04/2019

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