Provider Demographics
NPI:1902647159
Name:XANDER MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:XANDER MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ST. CLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-503-3475
Mailing Address - Street 1:36335 CANYON TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-5822
Mailing Address - Country:US
Mailing Address - Phone:909-503-3475
Mailing Address - Fax:
Practice Address - Street 1:36335 CANYON TERRACE DR
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-5822
Practice Address - Country:US
Practice Address - Phone:909-503-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty