Healthcare Provider Details

I. General information

NPI: 1063377539
Provider Name (Legal Business Name): ALEXANDER BEHLENDORF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22122 SHERMAN WAY STE 105
CANOGA PARK CA
91303-1159
US

IV. Provider business mailing address

5322 AGNES AVE
VALLEY VILLAGE CA
91607-2704
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-2787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: