Healthcare Provider Details

I. General information

NPI: 1265803126
Provider Name (Legal Business Name): ALEXANDRA ROUNDS LM, BS, CLD,CPD, CBC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W CLAY ST
UKIAH CA
95482-5452
US

IV. Provider business mailing address

4701 RIDGEWOOD RD
WILLITS CA
95490-7747
US

V. Phone/Fax

Practice location:
  • Phone: 707-391-9353
  • Fax:
Mailing address:
  • Phone: 707-391-9353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number591
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-305639
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: