Provider Demographics
NPI:1134977317
Name:KABEIREHO, ALEX (PMHNP)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:KABEIREHO
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 E 40TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-7994
Mailing Address - Country:US
Mailing Address - Phone:928-482-2426
Mailing Address - Fax:
Practice Address - Street 1:3250 E 40TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-7994
Practice Address - Country:US
Practice Address - Phone:928-482-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152875363LP0808X
AZ304773363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health