Provider Demographics
NPI:1376921171
Name:ALEXIS MARSON LMFT
Entity Type:Organization
Organization Name:ALEXIS MARSON LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:916-677-7187
Mailing Address - Street 1:991 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5249
Mailing Address - Country:US
Mailing Address - Phone:916-677-7187
Mailing Address - Fax:
Practice Address - Street 1:991 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5249
Practice Address - Country:US
Practice Address - Phone:916-677-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80115251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health