Provider Demographics
NPI:1699085019
Name:ALVAREZMEJIA, JAIME WALTER (INTERN)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:WALTER
Last Name:ALVAREZMEJIA
Suffix:
Gender:M
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 ROWE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6591
Mailing Address - Country:US
Mailing Address - Phone:360-471-2475
Mailing Address - Fax:
Practice Address - Street 1:1701 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1727
Practice Address - Country:US
Practice Address - Phone:415-452-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool