Provider Demographics
NPI:1619364445
Name:YOUKHANNEH-MORALES, ALEXSANDRA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:ALEXSANDRA
Middle Name:
Last Name:YOUKHANNEH-MORALES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BROOKSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-6267
Mailing Address - Country:US
Mailing Address - Phone:213-388-3151
Mailing Address - Fax:213-368-3315
Practice Address - Street 1:3160 GENEVA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1117
Practice Address - Country:US
Practice Address - Phone:213-388-3151
Practice Address - Fax:213-368-3315
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA834268163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse