Provider Demographics
NPI:1043016884
Name:FAKIH, ALEXANDRA FREDIANI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:FREDIANI
Last Name:FAKIH
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S VISTA DEL CANON
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3836
Mailing Address - Country:US
Mailing Address - Phone:714-478-5468
Mailing Address - Fax:
Practice Address - Street 1:505 N EUCLID ST STE 680
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5509
Practice Address - Country:US
Practice Address - Phone:714-780-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist