Healthcare Provider Details

I. General information

NPI: 1275377756
Provider Name (Legal Business Name): ALEXANDRA GRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 GATEWAY PL STE 230E
SAN JOSE CA
95110-3719
US

IV. Provider business mailing address

335 BUCKINGHAM WAY APT 501
SAN FRANCISCO CA
94132-1813
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-1493
  • Fax:
Mailing address:
  • Phone: 914-575-7910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: