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General NPI Number Information
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NPI Number | 1578448577
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Entity Type | Individual
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Provider Name | ALEXIS ALBERTA BAEZ
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Gender | Female
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 3818 MADISON AVE APT 19
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-5061
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Country | US
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Telephone | 209-882-2112
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Fax |
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Provider Business Mailing Address
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Address Line | 10898 BOESSOW RD
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City | GALT
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State | CA
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Zip | 95632-8451
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Country | US
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Telephone | 209-882-2112
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 101YA0400X
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License Number State | CA
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