Provider Demographics
NPI:1063714665
Name:CARRASCO, ALEJANDRA (LMFT)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:930 TRUXTUN AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4700
Mailing Address - Country:US
Mailing Address - Phone:661-475-8228
Mailing Address - Fax:661-215-0950
Practice Address - Street 1:1909 16TH ST STE 6
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5004
Practice Address - Country:US
Practice Address - Phone:661-475-8228
Practice Address - Fax:661-215-0950
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT114545106H00000X
171M00000X
CA76734106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator