Provider Demographics
NPI:1023853959
Name:SHOAR, LEXA
Entity type:Individual
Prefix:
First Name:LEXA
Middle Name:
Last Name:SHOAR
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 1:1815 S WESTSIDE DR UNIT 5076
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-8680
Mailing Address - Country:US
Mailing Address - Phone:949-712-8152
Mailing Address - Fax:
Practice Address - Street 1:307 PLACENTIA AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3310
Practice Address - Country:US
Practice Address - Phone:949-393-2240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach