Provider Demographics
NPI:1790180073
Name:HANSEN-ANKERSTAR, ALEXANDRA AMBER (LMFT, MA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:AMBER
Last Name:HANSEN-ANKERSTAR
Suffix:
Gender:F
Credentials:LMFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5996
Mailing Address - Country:US
Mailing Address - Phone:147-480-6650
Mailing Address - Fax:
Practice Address - Street 1:2801 BRISTOL ST
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5996
Practice Address - Country:US
Practice Address - Phone:714-480-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2023-11-09
Deactivation Date:2018-06-11
Deactivation Code:
Reactivation Date:2023-06-19
Provider Licenses
StateLicense IDTaxonomies
CA83965106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist