Individual
DR. ALEXANDREA PARK
Active
Individual
DR. ALEXANDREA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
25773
CA
103T00000X
Psychologist
25773
CA
103TA0700X
Adult Development & Aging Psychologist
25773
CA
103TC0700X
Clinical Psychologist
25773
CA
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0200X
Forensic Psychologist
25773
CA
103TH0004X
Health Psychologist
25773
CA
103TP2701X
Group Psychotherapy Psychologist
25773
CA
103TR0400X
Rehabilitation Psychologist
25773
CA
Other
Enumeration date
09/27/2011
Last updated
10/02/2013
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