Provider Demographics
NPI:1023361185
Name:SCHNACK, ALEXANDRA RAE
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RAE
Last Name:SCHNACK
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 1:1200 N MAIN ST
Mailing Address - Street 2:SUITE 630
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3640
Mailing Address - Country:US
Mailing Address - Phone:714-824-8150
Mailing Address - Fax:714-824-8151
Practice Address - Street 1:1200 N MAIN ST
Practice Address - Street 2:SUITE 630
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3640
Practice Address - Country:US
Practice Address - Phone:714-824-8150
Practice Address - Fax:714-824-8151
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor