Healthcare Provider Details

I. General information

NPI: 1306593504
Provider Name (Legal Business Name): ALAN HARMEZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3288 EL CAJON BLVD., SUITE 13
SAN DIEGO CA
92104
US

IV. Provider business mailing address

10051 TRENCHARD ST
SANTEE CA
92071-1174
US

V. Phone/Fax

Practice location:
  • Phone: 619-521-5770
  • Fax:
Mailing address:
  • Phone: 619-792-2369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19050
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: