Provider Demographics
NPI:1144943481
Name:ALVAREZ, SAMUEL ROJAS
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:ROJAS
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:SAMUEL
Other - Middle Name:ROJAS
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:811 N RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-2782
Mailing Address - Country:US
Mailing Address - Phone:805-266-9532
Mailing Address - Fax:800-417-9245
Practice Address - Street 1:116 AGNES AVE
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-2838
Practice Address - Country:US
Practice Address - Phone:805-457-3724
Practice Address - Fax:800-417-9245
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
172V00000X, 175T00000X, 372600000X, 373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist
No372600000XNursing Service Related ProvidersAdult Companion