Provider Demographics
NPI:1164685616
Name:ALSHVANG, SVETLANA (PSYD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:ALSHVANG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 DISCOVERY WAY
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-5005
Mailing Address - Country:US
Mailing Address - Phone:650-224-3223
Mailing Address - Fax:
Practice Address - Street 1:1151 DISCOVERY WAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-5005
Practice Address - Country:US
Practice Address - Phone:650-224-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-04
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26385103T00000X
CA$$$$$$$$$101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor