Individual
ALEXANDRA BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Mailing address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
96790
CA
1041C0700X
Clinical Social Worker
Primary
96790
CA
Other
Enumeration date
02/22/2022
Last updated
04/08/2026
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