Provider Demographics
NPI:1720654254
Name:MOLINA, ALESSANDRA (MA, APCC, PPS)
Entity Type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MA, APCC, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 N SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2682
Mailing Address - Country:US
Mailing Address - Phone:323-828-1989
Mailing Address - Fax:
Practice Address - Street 1:5619 N FIGUEROA ST
Practice Address - Street 2:SUITE 228
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4979
Practice Address - Country:US
Practice Address - Phone:213-699-4723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
CA7183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool