Provider Demographics
NPI:1174907810
Name:ANAHEIM HILLS PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:ANAHEIM HILLS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-769-9050
Mailing Address - Street 1:PO BOX 17635
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-7635
Mailing Address - Country:US
Mailing Address - Phone:714-769-9050
Mailing Address - Fax:714-941-9199
Practice Address - Street 1:155 N RIVERVIEW DR
Practice Address - Street 2:STE. 209
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1225
Practice Address - Country:US
Practice Address - Phone:714-769-9050
Practice Address - Fax:714-941-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty