Provider Demographics
NPI:1013605583
Name:BERARD, ALEXANDRA BURNS (MA, AMFT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BURNS
Last Name:BERARD
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:CATHERINE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4182 DENKER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-1707
Mailing Address - Country:US
Mailing Address - Phone:408-621-0814
Mailing Address - Fax:
Practice Address - Street 1:4182 DENKER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-1707
Practice Address - Country:US
Practice Address - Phone:408-621-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137342106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist