Provider Demographics
NPI:1396586947
Name:INIGUEZ, ALIXEA
Entity type:Individual
Prefix:
First Name:ALIXEA
Middle Name:
Last Name:INIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 HEFFERNAN AVE
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-4718
Mailing Address - Country:US
Mailing Address - Phone:760-270-9126
Mailing Address - Fax:
Practice Address - Street 1:1116 RANCHO ELEGANTE DR
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-3319
Practice Address - Country:US
Practice Address - Phone:760-540-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst