MEDICARE: MICHELLE ALFARO

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	1041C0700X	Clinical Social Worker	113196	CA

General Provider Information

NPI Number	:	1477164523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ALFARO

Provider Business Mailing Address
First Line	:	333 S BEAUDRY AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1466
Country	:	US
Telephone Number	:	213-241-3841
Fax Number	:	213-241-3305

Provider Business Practice Location Address
First Line	:	6551 VAN NUYS BLVD FL 2
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1566
Country	:	US
Telephone Number	:	818-765-8656
Fax Number	:

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

Provider Enumeration Date	:	08/12/2020
Last Update Date	:	12/21/2023

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Directions to “ MICHELLE ALFARO ” Practice Location

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