Provider Demographics
NPI:1598523854
Name:BAJAJ, ALPA A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALPA
Middle Name:A
Last Name:BAJAJ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 BIG DIPPER DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8335
Mailing Address - Country:US
Mailing Address - Phone:951-443-8452
Mailing Address - Fax:
Practice Address - Street 1:15635 ALTON PKWY STE 350
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7333
Practice Address - Country:US
Practice Address - Phone:949-528-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94025805103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical