Provider Demographics
NPI:1528166808
Name:CHIARA, ALEXANDRA MAUREEN (PHD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MAUREEN
Last Name:CHIARA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DOVE ST STE 140
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2846
Mailing Address - Country:US
Mailing Address - Phone:949-300-4727
Mailing Address - Fax:
Practice Address - Street 1:1001 DOVE ST STE 140
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2846
Practice Address - Country:US
Practice Address - Phone:949-300-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20007103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical