Healthcare Provider Details

I. General information

NPI: 1245146109
Provider Name (Legal Business Name): ALEXANDRIA MARGARITA KALOUST MA, EDS, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEXXIE MARGARITA KALOUST MA EDS NCSP

II. Dates (important events)

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

III. Provider practice location address

4711 CAMPBELL AVE
SAN JOSE CA
95130-1790
US

IV. Provider business mailing address

1 MERCEDES BND
SCOTTS VALLEY CA
95066-2501
US

V. Phone/Fax

Practice location:
  • Phone: 408-874-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: