Individual provider · NPI-1

Bertha Alicia Carvallo, CNA

Foster Care Agency · El Paso, TX

NPI number1003391947
StatusActive
Last updated in NPPESSep 26, 2018

Details

NPI
1003391947
Entity type
Individual (NPI-1)
Name
Mrs. Bertha Alicia Carvallo
Credential
CNA
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 26, 2018
Last updated
Sep 26, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253J00000X Foster Care AgencyLHOC14-00102TXYes

Practice location

2725 Fillmore
El Paso, TX 79930

Phone 915-566-0353

Mailing address

2725 Fillmore
El Paso, TX 79930

Phone 915-566-0353

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