Healthcare Provider Details

I. General information

NPI: 1700446291
Provider Name (Legal Business Name): ESDRAS ALVIZURES PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 E COLORADO BLVD STE 2468
PASADENA CA
91106-1932
US

IV. Provider business mailing address

1308 E COLORADO BLVD STE 2468
PASADENA CA
91106-1932
US

V. Phone/Fax

Practice location:
  • Phone: 424-799-0673
  • Fax:
Mailing address:
  • Phone: 424-799-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: