Healthcare Provider Details

I. General information

NPI: 1386114833
Provider Name (Legal Business Name): ALEXANDER FIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 ROYAL OAKS DR STE 201
SACRAMENTO CA
95815
US

IV. Provider business mailing address

1901 ROYAL OAKS DR STE 201
SACRAMENTO CA
95815-4235
US

V. Phone/Fax

Practice location:
  • Phone: 916-923-1789
  • Fax:
Mailing address:
  • Phone: 916-923-1789
  • Fax: 323-866-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-63967
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: