Provider Demographics
NPI:1336924364
Name:HENDRIX, ALEXIS VICTORIA (RBT)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:VICTORIA
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40742 BROOKHOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-5620
Mailing Address - Country:US
Mailing Address - Phone:850-319-2320
Mailing Address - Fax:
Practice Address - Street 1:17702 SIERRA HWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-1635
Practice Address - Country:US
Practice Address - Phone:188-844-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician