Provider Demographics
NPI:1003523796
Name:DURAZO, ALEXANDRA JULIA
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JULIA
Last Name:DURAZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27502 AVENUE SCOTT STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3912
Mailing Address - Country:US
Mailing Address - Phone:661-670-2999
Mailing Address - Fax:
Practice Address - Street 1:27502 AVENUE SCOTT STE A
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-3912
Practice Address - Country:US
Practice Address - Phone:661-670-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician