Healthcare Provider Details

I. General information

NPI: 1992972624
Provider Name (Legal Business Name): ANTONELLA B ALUZRI PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 E WALKERTON ST 6511 E WALKERTON ST.
LONG BEACH CA
90808-2423
US

IV. Provider business mailing address

6511 E WALKERTON ST 6511 E WALKERTON ST.
LONG BEACH CA
90808-2423
US

V. Phone/Fax

Practice location:
  • Phone: 310-713-5342
  • Fax:
Mailing address:
  • Phone: 310-713-5342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 18462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: