Basic Information
| Provider Information | |||||||||
| NPI: | 1174018766 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANEL | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | HOLLAND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8413 W 4TH ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900484101 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1533 EUCLID ST | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904043306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104519747 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2018 | ||||||||
| LastUpdateDate: | 06/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.