Healthcare Provider Details

I. General information

NPI: 1720463565
Provider Name (Legal Business Name): KEVIN ALVEY MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37193 AVENUE 12 STE 3H
MADERA CA
93636-8756
US

IV. Provider business mailing address

16750 KAREN RD
MADERA CA
93636-8235
US

V. Phone/Fax

Practice location:
  • Phone: 559-970-5640
  • Fax:
Mailing address:
  • Phone: 559-970-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: