MEDICARE: DR. MICHAEL ANGEL AREVALO JR. PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY31191	CA

General Provider Information

NPI Number	:	1518423839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANGEL AREVALO JR. PSY.D.

Provider Business Mailing Address
First Line	:	196 W ASHLAND ST
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	949-298-6440
Fax Number	:

Provider Business Practice Location Address
First Line	:	196 W ASHLAND ST
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	949-298-6440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2019
Last Update Date	:	03/28/2023

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