Provider Demographics
NPI:1538545587
Name:ALCOCER, CRISTEL (PSYD)
Entity type:Individual
Prefix:
First Name:CRISTEL
Middle Name:
Last Name:ALCOCER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355TH MEDICAL GROUP
Mailing Address - Street 2:4175 SOUTH ALAMO AVENUE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-4405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355TH MEDICAL GROUP
Practice Address - Street 2:4175 S. ALAMO AVE.
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707-4405
Practice Address - Country:US
Practice Address - Phone:520-228-4926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
AZPSY-005122103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist