Provider Demographics
NPI:1083310676
Name:KRIGBAUM, ALEXANDRA (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KRIGBAUM
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1141 W SHAW AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3713
Mailing Address - Country:US
Mailing Address - Phone:559-428-3176
Mailing Address - Fax:
Practice Address - Street 1:1141 W SHAW AVE STE 203
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3713
Practice Address - Country:US
Practice Address - Phone:559-428-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT145141106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALMFT145141OtherBBS