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General NPI Number Information
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NPI Number | 1578117826
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Entity Type | Individual
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Provider Name | ALEX PRIMO LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 20121 DEVONSHIRE ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-3408
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Country | US
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Telephone | 818-875-9017
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Fax |
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Provider Business Mailing Address
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Address Line | 18017 CHATSWORTH ST STE 166
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5608
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Country | US
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Telephone | 818-875-9017
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 111633
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License Number State | CA
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