Provider Demographics
NPI:1285187849
Name:SERAFINI- TAPIA, ALEXANDRA ROSE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ROSE
Last Name:SERAFINI- TAPIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ALEXANDRA
Other - Middle Name:ROSE
Other - Last Name:SERAFINI-TAPIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27261 LAS RAMBLAS STE 220
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6468
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11780 CENTRAL AVE STE 205
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-6499
Practice Address - Country:US
Practice Address - Phone:877-527-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84376101YM0800X, 104100000X
390200000X, 171M00000X
CA1027011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA102701OtherBOARD OF BEHAVIORAL SCIENCES
CA84376OtherBOARD OF BEHAVIORAL SCIENCES