Healthcare Provider Details

I. General information

NPI: 1164373908
Provider Name (Legal Business Name): ALEXANDRA LAUREN FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12626 RIVERSIDE DR STE 409
VALLEY VILLAGE CA
91607-3451
US

IV. Provider business mailing address

12626 RIVERSIDE DR STE 409
VALLEY VILLAGE CA
91607-3451
US

V. Phone/Fax

Practice location:
  • Phone: 818-661-6306
  • Fax:
Mailing address:
  • Phone: 818-661-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT152283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: