Healthcare Provider Details

I. General information

NPI: 1821675810
Provider Name (Legal Business Name): ALEXANDER GRAHAM LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 POST ST
SAN FRANCISCO CA
94115-3464
US

IV. Provider business mailing address

5789 FUTURA WAY
SANTA ROSA CA
95409-4408
US

V. Phone/Fax

Practice location:
  • Phone: 650-727-0194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: