Healthcare Provider Details

I. General information

NPI: 1467159921
Provider Name (Legal Business Name): ALEXANDRA SMITH-STOCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BERRY ST LBBY 1
SAN FRANCISCO CA
94107-5705
US

IV. Provider business mailing address

1721 W 35TH ST
AUSTIN TX
78703-1320
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-4533
  • Fax: 415-502-4717
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034729
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1101642
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: