Provider Demographics
NPI:1710243019
Name:ALEJO, ALEX (LMFT)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:ALEJO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39350 CIVIC CENTER DR FL 4
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2343
Mailing Address - Country:US
Mailing Address - Phone:510-494-4028
Mailing Address - Fax:
Practice Address - Street 1:39350 CIVIC CENTER DR FL 4
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2343
Practice Address - Country:US
Practice Address - Phone:510-494-4028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74304106H00000X
CA112065390200000X
CA140187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program