Individual
ALEXANDRA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15339 SATICOY ST, VAN NUYS, CA 91406-3345
(818) 267-2631
Mailing address
15339 SATICOY ST, VAN NUYS, CA 91406-3345
(818) 267-2631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
59998
CA
1041C0700X
Clinical Social Worker
59998
CA
1041C0700X
Clinical Social Worker
Primary
LCSW92906
CA
Other
Enumeration date
04/28/2015
Last updated
03/03/2021
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