MEDICARE: MRS. TERESA ALVARADO LMFT

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	106H00000X	Marriage & Family Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C5674549	OTHER	CA	CALIFORNIA DRIVERS LICENSE

General Provider Information

NPI Number	:	1336454065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA ALVARADO LMFT

Provider Business Mailing Address
First Line	:	3610 CENTRAL AVE STE 500
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-5907
Country	:	US
Telephone Number	:	952-285-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 CENTRAL AVE STE 500
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-5907
Country	:	US
Telephone Number	:	951-285-0510
Fax Number	:

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

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	01/26/2022

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