Provider Demographics
NPI:1730765439
Name:ALVAREZ-MENDOZA, NORMA FAVIOLA
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:FAVIOLA
Last Name:ALVAREZ-MENDOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:FAIVIOLA
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6276 N 1ST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5400
Mailing Address - Country:US
Mailing Address - Phone:559-712-4300
Mailing Address - Fax:
Practice Address - Street 1:6276 N 1ST ST STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5400
Practice Address - Country:US
Practice Address - Phone:559-712-4300
Practice Address - Fax:559-412-7564
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CAAMFT133054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAMFT133054OtherBOARD OF BEHAVIORAL HEALTH