Provider Demographics
NPI:1063924777
Name:ALVAREZ, AMY L (MS, LMFT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25020 LAS BRISAS RD STE 208
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4064
Mailing Address - Country:US
Mailing Address - Phone:951-398-1976
Mailing Address - Fax:951-398-4445
Practice Address - Street 1:25020 LAS BRISAS RD STE 208
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4064
Practice Address - Country:US
Practice Address - Phone:951-398-1976
Practice Address - Fax:951-398-4445
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist