Provider Demographics
NPI:1831763531
Name:REID, ALEXIS RAE (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAE
Last Name:REID
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14906 RIVAWILL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3736
Mailing Address - Country:US
Mailing Address - Phone:858-382-5996
Mailing Address - Fax:
Practice Address - Street 1:14906 RIVAWILL CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3736
Practice Address - Country:US
Practice Address - Phone:858-382-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist