Healthcare Provider Details

I. General information

NPI: 1942026091
Provider Name (Legal Business Name): ALEJANDRA IZZO ED.S., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEJANDRA VARGAS ED.S., M.S.

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19712 MACARTHUR BLVD STE 215
IRVINE CA
92612-2407
US

IV. Provider business mailing address

6517 CRAFTON AVE
BELL CA
90201-2805
US

V. Phone/Fax

Practice location:
  • Phone: 949-431-6914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4726
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number13826
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: