Provider Demographics
NPI:1114798527
Name:SALDIVAR, ALEXANDRA (MA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:SALDIVAR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:M
Other - Last Name:BARBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1874 SAINT LAKES WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-4672
Mailing Address - Country:US
Mailing Address - Phone:209-597-4432
Mailing Address - Fax:
Practice Address - Street 1:1874 SAINT LAKES WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-4672
Practice Address - Country:US
Practice Address - Phone:209-597-4432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician