MEDICARE: MARIA VERONICA 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	:	1902467343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA VERONICA ALVAREZ

Provider Business Mailing Address
First Line	:	1274 CENTER COURT DR STE 211
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91724-3668
Country	:	US
Telephone Number	:	909-252-9478
Fax Number	:

Provider Business Practice Location Address
First Line	:	6155 PALM AVE APT 3606
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92407-2095
Country	:	US
Telephone Number	:	909-252-9478
Fax Number	:

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

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	04/10/2025

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