Provider Demographics
NPI:1669880688
Name:ABEL, ALYXANDRIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALYXANDRIA
Middle Name:
Last Name:ABEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALYXANDRIA
Other - Middle Name:
Other - Last Name:BUFFUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3294 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3294 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2426
Practice Address - Country:US
Practice Address - Phone:562-988-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist