Provider Demographics
NPI:1457691008
Name:VACHON, ALEJANDRA V (LMFT)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:V
Last Name:VACHON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 COUNTRY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-4818
Mailing Address - Country:US
Mailing Address - Phone:909-623-3400
Mailing Address - Fax:
Practice Address - Street 1:30 COUNTRY WOOD DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-4818
Practice Address - Country:US
Practice Address - Phone:909-623-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF74022101YM0800X, 106H00000X
CAAMFT110973101YM0800X, 106H00000X
CALMFT118401106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health