Provider Demographics
NPI:1417409921
Name:CONTRERAS, ALEJANDRA PEZOA (BA)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:PEZOA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 STAYNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-2645
Mailing Address - Country:US
Mailing Address - Phone:408-281-5963
Mailing Address - Fax:
Practice Address - Street 1:1345 STAYNER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-2645
Practice Address - Country:US
Practice Address - Phone:408-281-5963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF1890488103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst