Healthcare Provider Details

I. General information

NPI: 1770431124
Provider Name (Legal Business Name): ALEXANDRIA DEVI SUBRAHMANYAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CORBETT AVE
SAN FRANCISCO CA
94114-2220
US

IV. Provider business mailing address

2111 43RD AVE
SAN FRANCISCO CA
94116-1528
US

V. Phone/Fax

Practice location:
  • Phone: 415-522-6757
  • Fax:
Mailing address:
  • Phone: 415-627-8826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number117434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: