Healthcare Provider Details

I. General information

NPI: 1497417729
Provider Name (Legal Business Name): ALEXA LETICIA NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82704 MILES AVE
INDIO CA
92201-4230
US

IV. Provider business mailing address

82704 MILES AVE
INDIO CA
92201-4230
US

V. Phone/Fax

Practice location:
  • Phone: 760-342-5727
  • Fax: 760-342-5674
Mailing address:
  • Phone: 760-342-5727
  • Fax: 760-342-5674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: