Basic Information
| Provider Information | |||||||||
| NPI: | 1821072679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIX | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | PHD LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7434 PASADENA CIR | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023938149 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2101 S 42ND ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681052947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025533000 | ||||||||
| FaxNumber: | 4025527444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TA0700X | 165 | NE | Y | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
No ID Information.