Provider Demographics
NPI:1336791441
Name:WARRINGTON, ALEXANDRA ARIANNA (MED)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ARIANNA
Last Name:WARRINGTON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21076 MINNETONKA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-7016
Mailing Address - Country:US
Mailing Address - Phone:760-780-7451
Mailing Address - Fax:
Practice Address - Street 1:21076 MINNETONKA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-7016
Practice Address - Country:US
Practice Address - Phone:760-780-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician