Provider Demographics
NPI:1669099982
Name:ROSAS-PIMENTEL, ALEXA
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:ROSAS-PIMENTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:ROSAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:169 MASON ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4482
Mailing Address - Country:US
Mailing Address - Phone:707-463-3300
Mailing Address - Fax:
Practice Address - Street 1:169 MASON ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4482
Practice Address - Country:US
Practice Address - Phone:707-463-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health