Healthcare Provider Details

I. General information

NPI: 1154334878
Provider Name (Legal Business Name): ALEX ROSSMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5727 LEONA ST
OAKLAND CA
94605-1224
US

IV. Provider business mailing address

5727 LEONA ST
OAKLAND CA
94605-1224
US

V. Phone/Fax

Practice location:
  • Phone: 617-775-8977
  • Fax:
Mailing address:
  • Phone: 617-775-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number82289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: