Healthcare Provider Details

I. General information

NPI: 1356448096
Provider Name (Legal Business Name): ALEXANDER DUNWODY BINGHAM PSY D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N POINT ST
SAN FRANCISCO CA
94133-1550
US

IV. Provider business mailing address

100 N POINT ST
SAN FRANCISCO CA
94133-1550
US

V. Phone/Fax

Practice location:
  • Phone: 415-986-4029
  • Fax: 415-986-4015
Mailing address:
  • Phone: 415-986-4029
  • Fax: 415-986-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 19275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: