Healthcare Provider Details

I. General information

NPI: 1033871207
Provider Name (Legal Business Name): ALEXANDRA CLEMANS APPLE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PARNASSUS AVE
SAN FRANCISCO CA
94143-2211
US

IV. Provider business mailing address

401 PARNASSUS AVE
SAN FRANCISCO CA
94143-2211
US

V. Phone/Fax

Practice location:
  • Phone: 724-300-3789
  • Fax:
Mailing address:
  • Phone: 650-207-6601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY32545
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY32545
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY32545
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY32545
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY32545
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY32545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: