Provider Demographics
NPI:1972814523
Name:ALEXANDER, FELICIA SHAREE
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:SHAREE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2517
Mailing Address - Country:US
Mailing Address - Phone:909-360-8526
Mailing Address - Fax:
Practice Address - Street 1:1206 W 14TH ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2517
Practice Address - Country:US
Practice Address - Phone:909-360-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator