Provider Demographics
NPI:1407642127
Name:ALFARO, ABIGAIL MIA
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MIA
Last Name:ALFARO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73733 COUNTRY CLUB DR APT 1219
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-8689
Mailing Address - Country:US
Mailing Address - Phone:442-434-8695
Mailing Address - Fax:
Practice Address - Street 1:73733 COUNTRY CLUB DR APT 1219
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-8689
Practice Address - Country:US
Practice Address - Phone:442-434-8695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician