ALEXIS AMANDA ODOM (NPI# 1164035788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164035788 |
| Entity Type | Individual |
| Full Name | ALEXIS AMANDA ODOM |
| Practice Address |
1632 E Dimondale Dr Carson CA 90746-2915 |
| Mailing Address |
5400 Orangethorpe Ave Apt 58 La Palma CA 90623-1043 |
| Practice Telephone | 3107913064 |
| Mailing Telephone | 3107484871 |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1632 E DIMONDALE DR |
| City | CARSON |
| State | CA |
| Zip Code | 90746-2915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568912483 | Fleming & Barnes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1632 E Dimondale Dr, Carson, CA 90746-2915 | 2016-10-04 |
| 1245842111 | Amaura Hale | Case Manager/Care Coordinator | 1632 E Dimondale Dr, Carson, CA 90746-2915 | 2020-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172837 | Darren Nakano Chiropractic, Professional Corporation | Chiropractor | 460 East Carson Plaza Drive, Suite 116, Carson, CA 90746 | 2019-09-05 |
| 1205370079 | Natalie Bland | Nurse Practitioner | 454 E. Carson Plaza Drive Suite 211, Carson, CA 90746 | 2016-12-13 |
| 1891146767 | Francis O Okpan | Nurse Practitioner | 17546 Buttonwood Ln, Carson, CA 90746 | 2016-06-22 |
| 1689049371 | Fresenius Medical Care Long Beach, LLC | Clinic/Center | 20710 Leapwood Ave Ste E, Carson, CA 90746 | 2015-12-07 |
| 1447649108 | Brandi Glenn | Occupational Therapist | 17811 Hazelwood Court, Carson, CA 90746 | 2015-01-20 |
| 1700226263 | Allen Berger | Counselor | 460 Est. Carson Plaza Dr. #119, Carson, CA 90746 | 2013-06-28 |
| 1902147036 | Basen Inc | Counselor | 460 Carson Plaza Drive, Ste 106, Carson, CA 90746 | 2013-03-14 |
| 1811238298 | Basen Inc | Counselor | 460 E Carsin Plaza Dr, #106, Carson, CA 90746 | 2013-03-08 |
| 1871858084 | Joseph H. Rodd M.d. Inc | Psychiatry & Neurology | 20710 S. Leapwood Ave., Suite B, Carson, CA 90746 | 2012-07-13 |
| 1467718601 | Laquesha Shonte Robinson | Counselor | 460 E. Carson Plaza Drive, Suite 200, Carson, CA 90746 | 2012-04-02 |
| Find all providers in zip 90746 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114355591 | Shakoya Green | Counselor | 335 E Albertoni St # 200-630, Carson, CA 90746-1425 | 2013-10-23 |
| 1700226263 | Allen Berger | Counselor | 460 Est. Carson Plaza Dr. #119, Carson, CA 90746 | 2013-06-28 |
| 1629371133 | Latoia Odessa Lyons | Counselor | 19336 Tillman Ave, Carson, CA 90746-2430 | 2010-12-06 |
| 1053639443 | Clifton Blake Spires | Counselor | 460 E Carson Plaza Dr Ste 122, Childrens Bureau, Carson, CA 90746-3278 | 2010-05-10 |
| 1083800577 | Michelle Annqunet Porter | Counselor | 320 E Centerview Dr, Carson, CA 90746-1134 | 2007-09-19 |
| 1295928638 | Melanie N Lee | Counselor | 326 W 220th St, Carson, CA 90745-2849 | 2007-08-20 |
| 1538208285 | Evelyn A. Andalis | Counselor | 23609 Moneta Ave, Carson, CA 90745-5733 | 2007-02-06 |
| 1013408236 | Norma Evangelina Vargas | Counselor | 460 E Carson Plaza Dr Ste 100, Carson, CA 90746 | 2018-05-23 |
| 1083130942 | Liliana Dominguez | Counselor | 460 E Carson Plaza Dr Ste 102, Carson, CA 90746-3270 | 2017-08-22 |
| 1376069740 | Edna Rodriguez | Counselor | 460 E Carson Plaza Dr Ste 122, Carson, CA 90746-3278 | 2017-08-17 |
| Find all providers in CARSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.