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General NPI Number Information
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NPI Number | 1639305998
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Entity Type | Individual
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Provider Name | DR. ALEX R CAMPBELL
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Gender | Male
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 264 ARLINGTON AVE STE 2
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City | KENSINGTON
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State | CA
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Zip | 94707-1416
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Country | US
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Telephone | 415-971-1186
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Fax |
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Provider Business Mailing Address
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Address Line | 185 DRAKEWOOD PL
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City | NOVATO
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State | CA
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Zip | 94947-4681
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Country | US
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Telephone | 415-971-1186
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Fax | 415-366-1685
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1084718
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC30244
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License Number State | CA
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