Provider Demographics
NPI:1841516499
Name:DE VERA, ALLISON ANGELES (BA)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:ANGELES
Last Name:DE VERA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 BLOOMFIELD AVE
Mailing Address - Street 2:BUILDING #305-#307
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2015
Mailing Address - Country:US
Mailing Address - Phone:562-207-9660
Mailing Address - Fax:562-207-9680
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:BUILDING #305-#307
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-207-9660
Practice Address - Fax:562-207-9680
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health