Provider Demographics
NPI:1194380238
Name:ALVARADO, ANGELA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12223 HIGHLAND AVE STE 106-281
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2574
Mailing Address - Country:US
Mailing Address - Phone:909-344-7352
Mailing Address - Fax:
Practice Address - Street 1:12223 HIGHLAND AVE STE 106-281
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-2574
Practice Address - Country:US
Practice Address - Phone:909-344-7352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT111609106H00000X
CALMFT125073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist