Individual
DR. GORDON ALEXANDER ST.MARY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
10929 SOUTH ST STE 202B, CERRITOS, CA 90703-5368
(818) 326-3816
Mailing address
4920 ODESSA AVE, ENCINO, CA 91436-1219
(818) 817-2391
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17475
CA
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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