Individual
ALEXA WALTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
29863 SANTA MARGARITA PKWY STE 100, RANCHO SANTA MARGARITA, CA 92688-3625
(949) 713-3188
(949) 713-3189
Mailing address
29863 SANTA MARGARITA PKWY STE 100, RANCHO SANTA MARGARITA, CA 92688-3625
(949) 713-3188
(949) 713-3189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21939
CA
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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