Alexis Abernethy, PHD, CGP

Individual provider Active NPI Clinical Psychologist · Pasadena, CA

NPI 1760933386 · NPPES record last updated Oct 19, 2016

Key facts

NPI
1760933386
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
17059 (CA)
Practice address
180 N Oakland Ave
Pasadena, CA 91101-1714
Phone
(626) 584-5359
Fax
(626) 584-9630
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
17059CAMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 17059 CA Yes
Group Psychotherapy Psychologist 103TP2701X 17059 CA

Addresses

Primary practice location

180 N Oakland Ave
Pasadena, CA 91101-1714

Mailing address

180 N Oakland Ave
Pasadena, CA 91101-1714
Phone (626) 584-5359

Other providers in Pasadena, CA

All providers in Pasadena, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.