MEDICARE: AMARU ANDREA ALVAREZ FUENTES

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	235Z00000X	Speech-Language Pathologist	36468	CA

General Provider Information

NPI Number	:	1235062514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARU ANDREA ALVAREZ FUENTES

Provider Business Mailing Address
First Line	:	3854 R ST APT 5
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-2293
Country	:	US
Telephone Number	:	559-578-5158
Fax Number	:

Provider Business Practice Location Address
First Line	:	1491 GROVE AVE
Second Line	:
City	:	ATWATER
State	:	CA
Zip	:	95301-3531
Country	:	US
Telephone Number	:	209-357-9894
Fax Number	:

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

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ AMARU ANDREA ALVAREZ FUENTES ” Practice Location

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