Provider Demographics
NPI:1912499740
Name:GARZA-KJORVESTAD, ALEXIS ARIANA (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ARIANA
Last Name:GARZA-KJORVESTAD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:ARIANA
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ALEXIS ARIANA GARZA
Mailing Address - Street 1:2054 S HACIENDA BLVD UNIT 5784
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-7637
Mailing Address - Country:US
Mailing Address - Phone:657-234-0822
Mailing Address - Fax:
Practice Address - Street 1:6443 EAST SAMPLE AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727
Practice Address - Country:US
Practice Address - Phone:559-458-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA120010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)