Provider Demographics
NPI:1225055148
Name:YEVDAKIMOV RECHS, ALEXANDRA ELIZABETH (MA MFT)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ELIZABETH
Last Name:YEVDAKIMOV RECHS
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:YEVDAKIMOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA MFT INTERN
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-875-0847
Mailing Address - Fax:
Practice Address - Street 1:7001A EAST PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2501
Practice Address - Country:US
Practice Address - Phone:916-875-0847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000008462OtherMEDI-CAL PROVIDER NUMBER