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NPI Code Detail

MEDICARE: ALEXANDRA DESANTIS

MEDICARE: ALEXANDRA DESANTIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2103K00000XBehavior Analyst1-16-23250
3101YM0800XMental Health CounselorOR

General Provider Information

NPI Number : 1144643990
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA DESANTIS
Provider Business Mailing Address
First Line : 1215 SW G ST
Second Line :
City : GRANTS PASS
State : OR
Zip : 97526-2544
Country : US
Telephone Number : 541-476-2373
Fax Number :
Provider Business Practice Location Address
First Line : 200 BEATTY ST
Second Line :
City : MEDFORD
State : OR
Zip : 97501-5811
Country : US
Telephone Number : 541-476-2373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2014
Last Update Date : 02/03/2026

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Directions to “ ALEXANDRA DESANTIS ” Practice Location

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