Provider Demographics
NPI:1154805984
Name:ALFARO, ERICA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ALFARO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15056 ROSALITA DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-3922
Mailing Address - Country:US
Mailing Address - Phone:562-396-2421
Mailing Address - Fax:
Practice Address - Street 1:13710 STUDEBAKER RD STE 201
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3592
Practice Address - Country:US
Practice Address - Phone:562-450-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46641106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist