Provider Demographics
NPI:1013707462
Name:EASTHOUSE, ALEC ROBERT
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:ROBERT
Last Name:EASTHOUSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 LILY CT
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-9553
Mailing Address - Country:US
Mailing Address - Phone:831-245-6602
Mailing Address - Fax:
Practice Address - Street 1:7500 ARROYO CIR STE 180
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7339
Practice Address - Country:US
Practice Address - Phone:408-418-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty