Provider Demographics
NPI:1558692954
Name:ABSTON, ALVIN L
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:L
Last Name:ABSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ALVIN
Other - Middle Name:LEE
Other - Last Name:ABSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:8320 MISSION BLVD # 4
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92509-2970
Mailing Address - Country:US
Mailing Address - Phone:323-496-2202
Mailing Address - Fax:323-329-3630
Practice Address - Street 1:8320 MISSION BLVD # 4
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-2970
Practice Address - Country:US
Practice Address - Phone:323-496-2202
Practice Address - Fax:323-329-3630
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist