Provider Demographics
NPI:1598956526
Name:LEVY, ALAN WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WILLIAM
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 ALTON PKWY
Mailing Address - Street 2:SUITE 238
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3717
Mailing Address - Country:US
Mailing Address - Phone:951-737-2683
Mailing Address - Fax:949-825-5973
Practice Address - Street 1:150 PAULARINO AVE
Practice Address - Street 2:SUITE 185
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3301
Practice Address - Country:US
Practice Address - Phone:949-689-6334
Practice Address - Fax:949-825-5973
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 3522103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical