Provider Demographics
NPI:1447992128
Name:BLOCK, ALEXANDRA JEANNETTE (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JEANNETTE
Last Name:BLOCK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5632 VAN NUYS BLVD PO BOX #1398
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401
Mailing Address - Country:US
Mailing Address - Phone:805-660-2120
Mailing Address - Fax:
Practice Address - Street 1:13964 MARGATE ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5745
Practice Address - Country:US
Practice Address - Phone:805-660-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health