Healthcare Provider Details

I. General information

NPI: 1679437495
Provider Name (Legal Business Name): MRS. PAMELA VICTORIA ALVAREZ BRINTRUP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 HOLLYWOOD BLVD
LOS ANGELES CA
90027-6104
US

IV. Provider business mailing address

835 STANFORD AVE
LOS ANGELES CA
90021-1847
US

V. Phone/Fax

Practice location:
  • Phone: 213-250-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250087323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: