NPI Code Details Logo

NPI 1861157497

NPI 1861157497 : ALEXANDRIA DUONG ATC : PALO ALTO, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1861157497
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ALEXANDRIA DUONG ATC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/08/2021
-----------------------------------------------------
    Last Update Date     |    02/02/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    641 CAMPUS DR 
-----------------------------------------------------
    City                 |    PALO ALTO
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94305-6201
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    415-583-9063
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1269 45TH AVE 
-----------------------------------------------------
    City                 |    SAN FRANCISCO
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94122-1106
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    415-640-9509
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2255A2300X
-----------------------------------------------------
    Taxonomy Name        |    Athletic Trainer
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.