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Alexa Nichole Kidman
Mental Health Counselor in Fair Oaks, California
NPI 1760133300

Alexa Nichole Kidman is a Mental Health Counselor based in Sacramento, CA and is specialized in Mental Health. Alexa Nichole Kidman practices in Fair Oaks, CA. The NPI Number for Alexa Nichole Kidman is 1760133300 and holds a License No. 106466 (California).

The current practice location address for Alexa Nichole Kidman is 4125 Temescal St, Fair Oaks, CA and can be reached out via phone at 916-877-6894.

Location: 4125 Temescal St, Fair Oaks, CA, 95819-4608
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760133300
Provider Name
Alexa Nichole Kidman
Credential
Provider Entity Type
Individual
Gender
Female
Address
4125 Temescal St, Fair Oaks, CA, 95819-4608
Phone Number
916-877-6894
Fax Number
Provider Enumeration Date
01/14/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4125 Temescal St
City
Fair Oaks
State
California
Zip
95628-7558
Phone Number
916-877-6894
Fax Number
person
Provider Business Mailing Address Details
Address
4125 Temescal St
City
Fair Oaks
State
California
Zip
95628-7558
Phone Number
916-877-6894
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
106466 (California)
Definition
Definition to come...
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