Healthcare Provider Details

I. General information

NPI: 1407772585
Provider Name (Legal Business Name): ALEXANDRA ROSE STANKUS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 GEARY BLVD APT 18
SAN FRANCISCO CA
94121-1836
US

IV. Provider business mailing address

6340 GEARY BLVD APT 18
SAN FRANCISCO CA
94121-1836
US

V. Phone/Fax

Practice location:
  • Phone: 508-735-1281
  • Fax:
Mailing address:
  • Phone: 508-735-1281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: