Provider Demographics
NPI:1336272905
Name:ALEXANDER, DEBORAH SUSAN
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SUSAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2231
Mailing Address - Country:US
Mailing Address - Phone:310-393-1243
Mailing Address - Fax:310-393-3013
Practice Address - Street 1:1533 EUCLID ST
Practice Address - Street 2:FAMILY SERVICE OF SANTA MONICA
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3306
Practice Address - Country:US
Practice Address - Phone:310-451-9747
Practice Address - Fax:310-451-6156
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS106411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical