Provider Demographics
NPI:1982271151
Name:ALVAREZ, ARISSA ROMINA (LCSW)
Entity type:Individual
Prefix:
First Name:ARISSA
Middle Name:ROMINA
Last Name:ALVAREZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 E GARVEY AVE N STE B17
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1545
Mailing Address - Country:US
Mailing Address - Phone:626-489-9144
Mailing Address - Fax:
Practice Address - Street 1:2155 E GARVEY AVE N STE B17
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1545
Practice Address - Country:US
Practice Address - Phone:626-489-9144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1291331041C0700X
1041C0700X
CA97130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty