Provider Demographics
NPI:1811765183
Name:FELL, ALEXANDRA JOY (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JOY
Last Name:FELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:JOY
Other - Last Name:HEMPHILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:4968 BOOTH CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3366
Mailing Address - Country:US
Mailing Address - Phone:949-753-7475
Mailing Address - Fax:
Practice Address - Street 1:4968 BOOTH CIR STE 101
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3366
Practice Address - Country:US
Practice Address - Phone:949-753-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028341363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty