Provider Demographics
NPI:1316648009
Name:ARISTIZABAL, ALESSANDRA MARIA (ACSW)
Entity type:Individual
Prefix:MISS
First Name:ALESSANDRA
Middle Name:MARIA
Last Name:ARISTIZABAL
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 HANSON DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-8838
Mailing Address - Country:US
Mailing Address - Phone:703-268-8675
Mailing Address - Fax:
Practice Address - Street 1:2070 PEABODY RD STE 710
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6697
Practice Address - Country:US
Practice Address - Phone:707-975-6429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1137771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical