Healthcare Provider Details

I. General information

NPI: 1124315643
Provider Name (Legal Business Name): ALEXANDRA SUMMERFIELD GINSBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 CHANTILLY ST STE 122
RICHMOND VA
23230-3501
US

IV. Provider business mailing address

1 SAINT VINCENTS DR
SAN RAFAEL CA
94903-1504
US

V. Phone/Fax

Practice location:
  • Phone: 415-412-2515
  • Fax:
Mailing address:
  • Phone: 415-507-2000
  • Fax: 415-507-0842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: