Provider Demographics
NPI:1770735540
Name:ALDRED, ALEXANDRA (MA (PSYCHOLOGY))
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ALDRED
Suffix:
Gender:F
Credentials:MA (PSYCHOLOGY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3773 CRENSHAW BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-5850
Mailing Address - Country:US
Mailing Address - Phone:323-295-2060
Mailing Address - Fax:323-295-2954
Practice Address - Street 1:3773 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-5850
Practice Address - Country:US
Practice Address - Phone:323-295-2060
Practice Address - Fax:323-295-2954
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57837106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist