Provider Demographics
NPI:1386209740
Name:LEPE, ALEJANDRA (BA, RBT)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:LEPE
Suffix:
Gender:F
Credentials:BA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25660 CRENSHAW BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7162
Mailing Address - Country:US
Mailing Address - Phone:424-328-0801
Mailing Address - Fax:
Practice Address - Street 1:1348 253RD ST
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2806
Practice Address - Country:US
Practice Address - Phone:424-264-3408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-16-20607106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician