Healthcare Provider Details

I. General information

NPI: 1720992597
Provider Name (Legal Business Name): ALEXIA THOME DORNELES HOULSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 TARAVAL ST APT 2
SAN FRANCISCO CA
94116-2022
US

IV. Provider business mailing address

3525 TARAVAL ST APT 2
SAN FRANCISCO CA
94116-2022
US

V. Phone/Fax

Practice location:
  • Phone: 504-564-4675
  • Fax:
Mailing address:
  • Phone: 504-564-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: