Provider Demographics
NPI:1831351246
Name:ANASTASIOU, ALEXIS M (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:M
Last Name:ANASTASIOU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:M
Other - Last Name:ANASTASIOU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5890 STONERIDGE DR
Mailing Address - Street 2:#215
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5818
Mailing Address - Country:US
Mailing Address - Phone:925-425-0191
Mailing Address - Fax:925-399-5401
Practice Address - Street 1:5890 STONERIDGE DR
Practice Address - Street 2:#215
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5818
Practice Address - Country:US
Practice Address - Phone:925-425-0191
Practice Address - Fax:925-399-5401
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A121972084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program