Healthcare Provider Details

I. General information

NPI: 1093646184
Provider Name (Legal Business Name): ALEXANDER WARRICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10568 CALIFORNIA ST
REDLANDS CA
92373-6239
US

IV. Provider business mailing address

20 W LUGONIA AVE
REDLANDS CA
92374-2234
US

V. Phone/Fax

Practice location:
  • Phone: 909-307-2480
  • Fax:
Mailing address:
  • Phone:
  • Fax: 909-307-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: