Provider Demographics
NPI:1063722031
Name:TOVAR, ALEXIS RENEE (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:RENEE
Last Name:TOVAR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 MIRANDA AVE # 122
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1290
Mailing Address - Country:US
Mailing Address - Phone:831-884-1035
Mailing Address - Fax:831-884-1033
Practice Address - Street 1:201 9TH ST # MONT-122
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-6039
Practice Address - Country:US
Practice Address - Phone:831-884-1035
Practice Address - Fax:831-884-1033
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA741521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical