Provider Demographics
NPI:1780932236
Name:DALE, ALEXANDRIA PAIGE
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:PAIGE
Last Name:DALE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALEXANDRIA
Other - Middle Name:PAIGE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47950 DUNE PALMS RD
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4000
Mailing Address - Country:US
Mailing Address - Phone:760-771-8655
Mailing Address - Fax:
Practice Address - Street 1:47950 DUNE PALMS RD
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4000
Practice Address - Country:US
Practice Address - Phone:760-771-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100643106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist