Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043515265 |
---|---|
Provider Name | Mrs. Martha Patricia Alvarado |
First Address | Van Nuys, CA 91401-2346 |
Second Address | Van Nuys, CA 91401-2346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2011 |
Last Update Date | 03/03/2011 |