Individual
DR. ALEXANDREA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
9107 WILSHIRE BLVD STE 475, BEVERLY HILLS, CA 90210-5559
(310) 941-7775
(310) 771-0977
Mailing address
9663 SANTA MONICA BLVD # 1058, BEVERLY HILLS, CA 90210-4303
(310) 941-7775
(310) 771-0977
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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