Provider Demographics
NPI:1427181064
Name:ALFARO, MARIA GUADALUPE (MFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GUADALUPE
Last Name:ALFARO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 VAN NUYS BLVD STE 329
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3999
Mailing Address - Country:US
Mailing Address - Phone:818-744-7256
Mailing Address - Fax:
Practice Address - Street 1:6931 VAN NUYS BLVD STE 329
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3999
Practice Address - Country:US
Practice Address - Phone:818-744-7256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47737106H00000X
CA51598225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner