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General NPI Number Information
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NPI Number | 1285196998
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Entity Type | Individual
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Provider Name | ALEXANDRA TAKANIKOS NP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 1800 VINE ST STE 221
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City | LOS ANGELES
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State | CA
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Zip | 90028-5250
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Country | US
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Telephone | 619-327-9811
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Fax | 619-352-0970
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Provider Business Mailing Address
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Address Line | PO BOX 801280
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City | KANSAS CITY
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State | MO
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Zip | 64180-1280
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Country | US
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Telephone | 530-304-8066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95011451
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License Number State | CA
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