Individual
ALEXANDRA MARIE IZUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Mailing address
6999 HASTINGS ST, MOORPARK, CA 93021-1347
(805) 416-4508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396076147
PSYCHIATRIC HOSPITAL
CA
Enumeration date
04/06/2018
Last updated
04/06/2018
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