MEDICARE: MARTA ALVAREZ

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1205283694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTA ALVAREZ

Provider Business Mailing Address
First Line	:	1705 E 10TH ST
Second Line	:	104
City	:	LONG BEACH
State	:	CA
Zip	:	90813-6344
Country	:	US
Telephone Number	:	424-272-5238
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 E 10TH ST
Second Line	:	104
City	:	LONG BEACH
State	:	CA
Zip	:	90813-6344
Country	:	US
Telephone Number	:	424-272-5238
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	05/16/2016

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Directions to “ MARTA ALVAREZ ” Practice Location

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