Provider Demographics
NPI:1316379704
Name:PAXTON, AUNDREA MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AUNDREA
Middle Name:MICHELLE
Last Name:PAXTON
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 1:14845 SW MURRAY SCHOLLS DR.
Mailing Address - Street 2:STE 110 PMB 219
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9237
Mailing Address - Country:US
Mailing Address - Phone:562-334-2246
Mailing Address - Fax:
Practice Address - Street 1:1550 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3778
Practice Address - Country:US
Practice Address - Phone:949-270-2100
Practice Address - Fax:949-650-4458
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29708103TC0700X
OR3457103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical