Individual
ALISSA CHARVONIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1499 S TIPPECANOE AVE # A, SAN BERNARDINO, CA 92408-2920
(909) 799-3777
(909) 799-5999
Mailing address
11175 CAMPUS ST # A1120, LOMA LINDA, CA 92350-1700
(909) 558-8626
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35989
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578772323
TELECARE CAMARILLO
CA
Enumeration date
04/02/2018
Last updated
11/11/2025
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