Healthcare Provider Details

I. General information

NPI: 1578226213
Provider Name (Legal Business Name): ALEX BARRAGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7906 SANTA MONICA BLVD STE 214
WEST HOLLYWOOD CA
90046-5169
US

IV. Provider business mailing address

7906 SANTA MONICA BLVD STE 214
WEST HOLLYWOOD CA
90046-5169
US

V. Phone/Fax

Practice location:
  • Phone: 323-790-6004
  • Fax:
Mailing address:
  • Phone: 323-790-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT141874
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC18252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: