Provider Demographics
NPI:1619030210
Name:BRICKEN, ALEXANDER (MS)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:BRICKEN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 N BUSH ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-3914
Mailing Address - Country:US
Mailing Address - Phone:707-228-6760
Mailing Address - Fax:
Practice Address - Street 1:1120 S DORA ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-6340
Practice Address - Country:US
Practice Address - Phone:707-472-2319
Practice Address - Fax:707-472-2307
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator