Provider Demographics
NPI:1568911451
Name:GULBIS, ALEXANDRA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LYNN
Last Name:GULBIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:ISLETON
Mailing Address - State:CA
Mailing Address - Zip Code:95641
Mailing Address - Country:US
Mailing Address - Phone:818-697-8707
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 531
Practice Address - Street 2:
Practice Address - City:ISLETON
Practice Address - State:CA
Practice Address - Zip Code:95641
Practice Address - Country:US
Practice Address - Phone:818-697-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CACALCSW-115100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker