| Alianza Therapy, A Licensed Clinical Social Worker Corporation | |
|
1323 W West Covina Pkwy West Covina CA 91790-2802 | |
| (626) 608-1684 | |
| Not Available |
| Full Name | Alianza Therapy, A Licensed Clinical Social Worker Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1323 W West Covina Pkwy, West Covina, California |
| Authorized Official Name and Position | Marcela Roldan (MANAGER) |
| Authorized Official Contact | 6265336969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alianza Therapy, A Licensed Clinical Social Worker Corporation 554 S Edenfield Ave Covina CA 91723-2949 Ph: (626) 533-6969 | Alianza Therapy, A Licensed Clinical Social Worker Corporation 1323 W West Covina Pkwy West Covina CA 91790-2802 Ph: (626) 608-1684 |
| NPI Number | 1346024999 |
|---|---|
| Provider Enumeration Date | 08/23/2023 |
| Last Update Date | 08/23/2023 |
| Certification Date | 08/23/2023 |
| Medicare PECOS PAC ID | 7618321795 |
|---|---|
| Medicare Enrollment ID | O20230922001533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346024999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Marcela Roldan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801924667 PECOS PAC ID: 5890161384 Enrollment ID: I20230912002222 |
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