Provider Demographics
NPI:1699259770
Name:ALFARO, MARCELA GUADALUPE
Entity type:Individual
Prefix:MS
First Name:MARCELA
Middle Name:GUADALUPE
Last Name:ALFARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 GRAND AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3769
Mailing Address - Country:US
Mailing Address - Phone:510-506-7910
Mailing Address - Fax:
Practice Address - Street 1:180 GRAND AVE STE 225
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3769
Practice Address - Country:US
Practice Address - Phone:510-451-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician