Provider Demographics
NPI:1437155975
Name:ALPERT, DONALD L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:ALPERT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 CHAMBERS ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780
Mailing Address - Country:US
Mailing Address - Phone:949-653-9000
Mailing Address - Fax:714-460-5533
Practice Address - Street 1:2522 CHAMBERS ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:949-653-9000
Practice Address - Fax:714-460-5533
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17632103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1596034Medicaid
CACP17632Medicare ID - Type UnspecifiedMEDICARE