Healthcare Provider Details

I. General information

NPI: 1336523521
Provider Name (Legal Business Name): ALEXIS EWING M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FRANKLIN ST
SAN FRANCISCO CA
94102-4414
US

IV. Provider business mailing address

30 OTIS ST # 303
SAN FRANCISCO CA
94103-1292
US

V. Phone/Fax

Practice location:
  • Phone: 415-241-6000
  • Fax:
Mailing address:
  • Phone: 415-828-9219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: