Provider Demographics
NPI:1306440938
Name:VICTORIA, ALEXANDER CHRISTIAN (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CHRISTIAN
Last Name:VICTORIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 HOLLISTER AVE
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2389
Mailing Address - Country:US
Mailing Address - Phone:805-681-7781
Mailing Address - Fax:805-682-5379
Practice Address - Street 1:5385 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-2389
Practice Address - Country:US
Practice Address - Phone:805-681-7781
Practice Address - Fax:805-682-5379
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist