Provider Demographics
NPI:1992834188
Name:ROSS, ALEXANDRIA NIKITA
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:NIKITA
Last Name:ROSS
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 1:625 SOUTH FAIR OAKS
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-5805
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:
Practice Address - Street 1:625 SOUTH FAIR OAKS
Practice Address - Street 2:SUITE 300
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-5805
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner