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General NPI Number Information
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NPI Number | 1831999788
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Entity Type | Individual
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Provider Name | ALEXANDRA DIEMER AMFT
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Gender |
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 11949 JEFFERSON BLVD STE 102
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City | CULVER CITY
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State | CA
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Zip | 90230-6336
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Country | US
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Telephone | 323-419-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 7101 PLAYA VISTA DR APT 103
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City | PLAYA VISTA
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State | CA
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Zip | 90094-2238
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Country | US
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Telephone | 626-633-2587
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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 | 153345
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License Number State | CA
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