Healthcare Provider Details

I. General information

NPI: 1780593038
Provider Name (Legal Business Name): ALEXANDRA JOSFAN MA MFTC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARAPAHOE AVE STE 12
BOULDER CO
80302-5862
US

IV. Provider business mailing address

100 ARAPAHOE AVE STE 12
BOULDER CO
80302-5862
US

V. Phone/Fax

Practice location:
  • Phone: 720-465-1315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0015047
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: