Healthcare Provider Details

I. General information

NPI: 1285561696
Provider Name (Legal Business Name): ALEXANDER JERRELL FITZPATRICK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 NORTHGATE DR STE 530
SAN RAFAEL CA
94903-2586
US

IV. Provider business mailing address

1050 NORTHGATE DR STE 530
SAN RAFAEL CA
94903-2586
US

V. Phone/Fax

Practice location:
  • Phone: 415-488-5372
  • Fax:
Mailing address:
  • Phone: 415-488-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC37580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: