Healthcare Provider Details

I. General information

NPI: 1194662312
Provider Name (Legal Business Name): ALEXANDRA ROBERTS MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NORIEGA ST
SAN FRANCISCO CA
94122-4046
US

IV. Provider business mailing address

9 ROSEMARY CT
SAN FRANCISCO CA
94116-2913
US

V. Phone/Fax

Practice location:
  • Phone: 818-585-4784
  • Fax:
Mailing address:
  • Phone: 818-585-4784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number18561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: