Individual
DR. IVAN DEJESUS ALVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
425 W CENTRAL AVE STE 101A, LOMPOC, CA 93436-2806
(805) 741-7668
Mailing address
PO BOX 1931, LOMPOC, CA 93438-1931
(805) 293-1898
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3516
CA
103TS0200X
School Psychologist
Primary
210009309
CA
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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