Healthcare Provider Details

I. General information

NPI: 1821932120
Provider Name (Legal Business Name): ALEXANDRA WERTZ M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 OBERLIN DR STE 202
SAN DIEGO CA
92121-1743
US

IV. Provider business mailing address

7280 HYATT ST UNIT 4
SAN DIEGO CA
92111-6145
US

V. Phone/Fax

Practice location:
  • Phone: 760-405-1979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: