Healthcare Provider Details

I. General information

NPI: 1457842908
Provider Name (Legal Business Name): ALEXANDRA ROCHELLE MORRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA VAUGHN MD

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 BLUE RAVINE RD
FOLSOM CA
95630-4771
US

IV. Provider business mailing address

192 BLUE RAVINE RD
FOLSOM CA
95630-4771
US

V. Phone/Fax

Practice location:
  • Phone: 916-938-3373
  • Fax: 916-983-7037
Mailing address:
  • Phone: 916-983-3373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA165516
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: