Individual
ALEXANDRA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 WILSHIRE BLVD # 354, LOS ANGELES, CA 90010-1103
(650) 489-5123
Mailing address
PO BOX 910873, SAN DIEGO, CA 92191-0873
(650) 489-5123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/06/2025
Last updated
12/09/2025
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