Active NPI
Alexis Avila, PH.D
- Clinical Psychologist
- Anaheim, CA
National Provider Identifier
1669827176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25935
- Practice address
- 2400 E Katella Ave
Suite 800
Anaheim, CA 92806-5945 - Phone
- (714) 460-2777
- Fax
- (714) 460-2777
- NPI assigned
- May 3, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 25935 | CA | Primary |
Addresses
Primary practice location
2400 E Katella Ave
Suite 800
Anaheim, CA 92806-5945
Mailing address
2400 E Katella Ave
Suite 800
Anaheim, CA 92806-5945
Phone (714) 460-2777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25935 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1669827176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 E KATELLA AVE",
"address_2": "SUITE 800",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928065945",
"telephone_number": "714-460-2777",
"fax_number": "714-460-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 E KATELLA AVE",
"address_2": "SUITE 800",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928065945",
"telephone_number": "714-460-2777",
"fax_number": "714-460-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "ALEXIS",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-03",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.