Provider Demographics
NPI:1760521074
Name:ALEXANDER, MARYA JOCELYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARYA
Middle Name:JOCELYN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:EAST IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92650-0252
Mailing Address - Country:US
Mailing Address - Phone:714-712-8340
Mailing Address - Fax:
Practice Address - Street 1:1717 W ORANGEWOOD AVE
Practice Address - Street 2:SUITE I
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2040
Practice Address - Country:US
Practice Address - Phone:714-712-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA731462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry