Provider Demographics
NPI:1164704847
Name:WEINTRAUB, ALEXIS ERYN (PSYD)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:ERYN
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6778 VIA CASA DEL SOL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5954
Mailing Address - Country:US
Mailing Address - Phone:858-431-6316
Mailing Address - Fax:
Practice Address - Street 1:2892 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1719
Practice Address - Country:US
Practice Address - Phone:619-543-7498
Practice Address - Fax:619-543-7063
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program