Provider Demographics
NPI:1376786657
Name:LEDEZMA, ALEJANDRA ROXANA
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:ROXANA
Last Name:LEDEZMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 MCLAUGHLIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1403
Mailing Address - Country:US
Mailing Address - Phone:510-409-0284
Mailing Address - Fax:
Practice Address - Street 1:885 MCLAUGHLIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1403
Practice Address - Country:US
Practice Address - Phone:510-409-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker