Provider Demographics
NPI:1578394383
Name:ALEJANDRO, NATHALIE (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 S BEAR ST UNIT I
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7291
Mailing Address - Country:US
Mailing Address - Phone:623-986-5575
Mailing Address - Fax:
Practice Address - Street 1:1151 DOVE ST STE 202
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2853
Practice Address - Country:US
Practice Address - Phone:562-285-6776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145294101YM0800X
CA15956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health