Healthcare Provider Details

I. General information

NPI: 1528420445
Provider Name (Legal Business Name): ALEX DEMY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11434 B AVE
AUBURN CA
95603-2603
US

IV. Provider business mailing address

11434 B AVE
AUBURN CA
95603-2603
US

V. Phone/Fax

Practice location:
  • Phone: 530-886-3653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW124008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: