IVAN DEJESUS ALVAREZ, School Psychologist — NPI 1265137004 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1265137004

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TS0200X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, School

Box 32 Service Location & ZIP+4

425 W CENTRAL AVE STE 101A, LOMPOC, CA, 93436-2806

✓ 9-Digit EDI 837 ZIP+4 (93436-2806)

Practice Phone & Referral Fax

(805) 741-7668

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1265137004 (IVAN DEJESUS ALVAREZ, School Psychologist) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1265137004` (NPI-1 Individual Practitioner)
Provider / Legal Name	IVAN DEJESUS ALVAREZ, School Psychologist
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, School NUCC Code: `103TS0200X` (Psychologist, School)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	425 W CENTRAL AVE STE 101A, LOMPOC, CA, 93436-2806
Practice Telephone / Fax	Tel: (805) 741-7668
Administrative Mailing Address	PO BOX 1931, LOMPOC, CA, 93438-1931
Enumeration & Last Sync	Enumerated: 2023-04-03 \| CMS Record Updated: 2023-04-03

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

425 W CENTRAL AVE STE 101A, LOMPOC, CA, 93436-2806

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Plain-English Taxonomy & CMS Crosswalk (103TS0200X)

What Does Taxonomy Code 103TS0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TS0200X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, School"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, School for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (IVAN DEJESUS ALVAREZ, School Psychologist)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103TS0200X` — Psychologist, School Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, School	State: CA \| License: `210009309` \| Primary: Yes (Primary)
`103TM1800X` — Psychologist, Intellectual & Developmental Disabilities Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Intellectual & Developmental Disabilities	State: CA \| License: `3516` \| Primary: Secondary

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IVAN DEJESUS ALVAREZ, School Psychologist (NPI #1265137004)