Provider Demographics
NPI:1659826360
Name:TAN, ALEXANDRIA NOEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:NOEL
Last Name:TAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ALEXANDRIA
Other - Middle Name:NOEL
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12820 MONTBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6769
Mailing Address - Country:US
Mailing Address - Phone:916-225-6395
Mailing Address - Fax:
Practice Address - Street 1:12820 MONTBROOK WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6769
Practice Address - Country:US
Practice Address - Phone:916-225-6395
Practice Address - Fax:916-278-5491
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1164471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical