Provider Demographics
NPI:1376905646
Name:ENGEL, ALEXANDRA (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:849 ALMAR AVE STE C-333
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-5875
Mailing Address - Country:US
Mailing Address - Phone:415-722-9146
Mailing Address - Fax:
Practice Address - Street 1:849 ALMAR AVE STE C-333
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-5875
Practice Address - Country:US
Practice Address - Phone:415-722-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84017106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist