Provider Demographics
NPI:1750781357
Name:MAGGARD, ALEXA
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:MAGGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2945 HARDING ST STE 203B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1818
Mailing Address - Country:US
Mailing Address - Phone:949-516-0846
Mailing Address - Fax:949-347-7645
Practice Address - Street 1:2945 HARDING ST STE 203B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:949-516-0846
Practice Address - Fax:949-347-7645
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA962981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker