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NPI Code Detail

MEDICARE: ALEXANDRA RASEY-SMITH BCBA

MEDICARE: ALEXANDRA RASEY-SMITH BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1760090971
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA RASEY-SMITH BCBA
Provider Business Mailing Address
First Line : 315 CENTENNIAL WAY
Second Line :
City : TUSTIN
State : CA
Zip : 92780-3714
Country : US
Telephone Number : 949-250-1101
Fax Number : 949-250-1103
Provider Business Practice Location Address
First Line : 315 CENTENNIAL WAY
Second Line :
City : TUSTIN
State : CA
Zip : 92780-3714
Country : US
Telephone Number : 949-250-1101
Fax Number : 949-250-1103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2020
Last Update Date : 07/14/2020

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Directions to “ ALEXANDRA RASEY-SMITH BCBA” Practice Location

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