Provider Demographics
NPI:1043961733
Name:VEGA, ALEJANDRA (LCSW)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14748 TEXACO AVE APT D
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5756
Mailing Address - Country:US
Mailing Address - Phone:323-447-7129
Mailing Address - Fax:323-789-5693
Practice Address - Street 1:351 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1808
Practice Address - Country:US
Practice Address - Phone:323-447-7129
Practice Address - Fax:323-789-5693
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA800811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical