Provider Demographics
NPI:1952432015
Name:ALEGRIA, IRIS CATALINA (MFT)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:CATALINA
Last Name:ALEGRIA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:C
Other - Last Name:ALEGRIA CHAZENBALK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:11774 MOORPARK ST
Mailing Address - Street 2:'H'
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2123
Mailing Address - Country:US
Mailing Address - Phone:818-753-2969
Mailing Address - Fax:
Practice Address - Street 1:840 N AVENUE 66
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1508
Practice Address - Country:US
Practice Address - Phone:323-257-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist