Provider Demographics
NPI:1457971459
Name:IZAGUIRRE, ALEJANDRA
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:IZAGUIRRE
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 1:233 HOSKINS MILL LN APT D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-1486
Mailing Address - Country:US
Mailing Address - Phone:919-450-8016
Mailing Address - Fax:
Practice Address - Street 1:1055 E COLORADO BLVD STE 560
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2380
Practice Address - Country:US
Practice Address - Phone:888-805-0759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service