Provider Demographics
NPI:1356856645
Name:FELDT, ALEXANDER RAINER (LMFT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:RAINER
Last Name:FELDT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 E KATELLA AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5049
Mailing Address - Country:US
Mailing Address - Phone:949-285-9118
Mailing Address - Fax:
Practice Address - Street 1:1224 E KATELLA AVE STE 209
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5049
Practice Address - Country:US
Practice Address - Phone:562-248-6672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA102977106H00000X
CA122652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health