Healthcare Provider Details

I. General information

NPI: 1194000216
Provider Name (Legal Business Name): ALEXANDRA HAZEL RUDD-BARNARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3649 ATLANTIC AVE STE B
LONG BEACH CA
90807-3417
US

IV. Provider business mailing address

3649 ATLANTIC AVE STE B
LONG BEACH CA
90807-3417
US

V. Phone/Fax

Practice location:
  • Phone: 310-207-1720
  • Fax: 310-207-1638
Mailing address:
  • Phone: 310-207-1720
  • Fax: 310-207-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25369
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number019294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: