Provider Demographics
NPI:1992884316
Name:ALEXANDER, JOHN ROBERT (MFT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WILLIAMSBURG LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2238
Mailing Address - Country:US
Mailing Address - Phone:530-680-4391
Mailing Address - Fax:
Practice Address - Street 1:22 WILLIAMSBURG LN
Practice Address - Street 2:SUITE B
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2238
Practice Address - Country:US
Practice Address - Phone:530-680-4391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health