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General NPI Number Information
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NPI Number | 1609291947
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Entity Type | Individual
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Provider Name | ALEXANDRA MARIA PENA LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 815 N EL CENTRO AVE
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City | LOS ANGELES
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State | CA
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Zip | 90038-3805
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Country | US
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Telephone | 323-463-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 W GARVEY AVE N
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City | WEST COVINA
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State | CA
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Zip | 91790-2138
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Country | US
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Telephone | 626-960-4844
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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 | 101641
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 121647
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License Number State | CA
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