Provider Demographics
NPI:1013448661
Name:ALEJANDRE, ADRIANA ALEJANDRA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:ALEJANDRA
Last Name:ALEJANDRE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11145 TAMPA AVE STE 27A
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2274
Mailing Address - Country:US
Mailing Address - Phone:818-859-5023
Mailing Address - Fax:
Practice Address - Street 1:11145 TAMPA AVE STE 27A
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2274
Practice Address - Country:US
Practice Address - Phone:818-835-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist