Provider Demographics
NPI:1609097385
Name:DANG, ALEXANDER Q (MA; LMFT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:Q
Last Name:DANG
Suffix:
Gender:M
Credentials:MA; LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N SAN PEDRO RD
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4178
Mailing Address - Country:US
Mailing Address - Phone:415-473-4354
Mailing Address - Fax:415-473-4307
Practice Address - Street 1:10 N SAN PEDRO RD
Practice Address - Street 2:SUITE 1020
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4178
Practice Address - Country:US
Practice Address - Phone:415-473-4354
Practice Address - Fax:415-473-4307
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 51923106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist