Healthcare Provider Details
I. General information
NPI: 1083224711
Provider Name (Legal Business Name): ALEXANDRA LYNN HEPPERT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/06/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4063 BIRCH ST STE 220
NEWPORT BEACH CA
92660-2241
US
IV. Provider business mailing address
4063 BIRCH ST STE 220
NEWPORT BEACH CA
92660-2241
US
V. Phone/Fax
- Phone: 949-229-5708
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 118045 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 134312 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: