Healthcare Provider Details

I. General information

NPI: 1326966466
Provider Name (Legal Business Name): ALICIA SEPULVEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 LA MESA BLVD STE 7
LA MESA CA
91942-6208
US

IV. Provider business mailing address

361 VANCE ST APT 202
CHULA VISTA CA
91910-4585
US

V. Phone/Fax

Practice location:
  • Phone: 619-535-8709
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: