Provider Demographics
NPI:1568941847
Name:RASHDAN, ALEXIS EDDIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:EDDIE
Last Name:RASHDAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:EDDIE
Other - Last Name:HAMAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3491 KURTZ ST STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4430
Mailing Address - Country:US
Mailing Address - Phone:619-320-2404
Mailing Address - Fax:
Practice Address - Street 1:3491 KURTZ ST STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4430
Practice Address - Country:US
Practice Address - Phone:619-320-2404
Practice Address - Fax:619-340-3628
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1166521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical