Provider Demographics
NPI:1407440845
Name:GOLD, ALEXIS (LMFT #129649)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:LMFT #129649
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6436 LUBAO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2713
Mailing Address - Country:US
Mailing Address - Phone:310-463-2794
Mailing Address - Fax:
Practice Address - Street 1:6436 LUBAO AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2713
Practice Address - Country:US
Practice Address - Phone:310-463-2794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty