Provider Demographics
NPI:1922602630
Name:DUGGAN, ALEXANDRIA YVETTE (MFT TRAINEE, SUDCC)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:YVETTE
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MFT TRAINEE, SUDCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 RICARDO AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2653
Mailing Address - Country:US
Mailing Address - Phone:530-722-1114
Mailing Address - Fax:530-722-1115
Practice Address - Street 1:3617 RICARDO AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2653
Practice Address - Country:US
Practice Address - Phone:530-722-1114
Practice Address - Fax:530-722-1115
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CA11154101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist