Basic Information
| Provider Information | |||||||||
| NPI: | 1598956526 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVY | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5405 ALTON PKWY | ||||||||
| Address2: | SUITE 238 | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926043717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517372683 | ||||||||
| FaxNumber: | 9498255973 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 PAULARINO AVE | ||||||||
| Address2: | SUITE 185 | ||||||||
| City: | COSTA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926263301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496896334 | ||||||||
| FaxNumber: | 9498255973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2007 | ||||||||
| LastUpdateDate: | 01/12/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY 3522 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.