Individual
DR. DEBRA ALEXA VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
4195 N VIKING WAY, SUITE 250, LONG BEACH, CA 90808-1466
(562) 254-1148
Mailing address
4195 N VIKING WAY, SUITE 250, LONG BEACH, CA 90808-1466
(562) 254-1148
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY14693
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPL146930
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
02/15/2007
Last updated
07/16/2008
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