Healthcare Provider Details

I. General information

NPI: 1881518058
Provider Name (Legal Business Name): ALEXIS NALANI SCARBOROUGH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 4TH ST STE 47
PETALUMA CA
94952-7402
US

IV. Provider business mailing address

40 4TH ST # 203
PETALUMA CA
94952-3040
US

V. Phone/Fax

Practice location:
  • Phone: 415-336-9553
  • Fax:
Mailing address:
  • Phone: 415-336-9553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: