Basic Information
| Provider Information | |||||||||
| NPI: | 1093027781 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | KRISTA | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3887 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947030887 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1936 CARLOTTA DR | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945191358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256828000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2010 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | N | Behavioral Health & Social Service Providers | Psychologist | School | 101YM0800X | 57932 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | 53567 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.