Healthcare Provider Details

I. General information

NPI: 1104659937
Provider Name (Legal Business Name): BRIANA ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 710145
SAN DIEGO CA
92171-0145
US

IV. Provider business mailing address

PO BOX 710145
SAN DIEGO CA
92171-0145
US

V. Phone/Fax

Practice location:
  • Phone: 619-346-4020
  • Fax:
Mailing address:
  • Phone: 619-346-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140297
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: