Provider Demographics
NPI:1093175192
Name:RAZO, ALEJANDRA (ASW, MSW)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:RAZO
Suffix:
Gender:F
Credentials:ASW, MSW
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:RAZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1904 RICHLAND AVE STE C2
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-4562
Mailing Address - Country:US
Mailing Address - Phone:209-558-4600
Mailing Address - Fax:
Practice Address - Street 1:1904 RICHLAND AVE STE C2
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4562
Practice Address - Country:US
Practice Address - Phone:209-558-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101401101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator