Healthcare Provider Details

I. General information

NPI: 1790180073
Provider Name (Legal Business Name): ALEXANDRA AMBER HANSEN-ANKERSTAR LMFT, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date: 06/11/2018
Reactivation Date: 06/19/2023

III. Provider practice location address

1107 E CHAPMAN AVE STE 203
ORANGE CA
92866-2130
US

IV. Provider business mailing address

1107 E CHAPMAN AVE STE 203
ORANGE CA
92866-2130
US

V. Phone/Fax

Practice location:
  • Phone: 714-714-6312
  • Fax:
Mailing address:
  • Phone: 714-714-6312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: