Healthcare Provider Details

I. General information

NPI: 1972423374
Provider Name (Legal Business Name): ALEXANDRA MANDEL LEP, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 CAMBRIAN DR
CAMPBELL CA
95008-5530
US

IV. Provider business mailing address

680 CAMBRIAN DR
CAMPBELL CA
95008-5530
US

V. Phone/Fax

Practice location:
  • Phone: 408-427-7063
  • Fax:
Mailing address:
  • Phone: 408-427-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW97527
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP4558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: