Provider Demographics
NPI:1427844562
Name:SHAY, ALIXANDERIA LEE (MSOM)
Entity type:Individual
Prefix:MS
First Name:ALIXANDERIA
Middle Name:LEE
Last Name:SHAY
Suffix:
Gender:
Credentials:MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 E VILLA RD
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-9708
Mailing Address - Country:US
Mailing Address - Phone:858-220-1033
Mailing Address - Fax:
Practice Address - Street 1:80 E VILLA RD
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-9708
Practice Address - Country:US
Practice Address - Phone:858-220-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program