Provider Demographics
NPI:1134715451
Name:GROSS, ALEXANDRA E (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:E
Last Name:GROSS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11341 NATIONAL BLVD # 1036
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3726
Mailing Address - Country:US
Mailing Address - Phone:818-457-9489
Mailing Address - Fax:
Practice Address - Street 1:4455 CONNECTICUT AVE NW APT 925
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2363
Practice Address - Country:US
Practice Address - Phone:818-457-9489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140883106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist