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NPI Code Detail

MEDICARE: ALEXANDER GRAHAM LMFT

MEDICARE: ALEXANDER GRAHAM LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist149876CA

General Provider Information

NPI Number : 1821675810
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER GRAHAM LMFT
Provider Business Mailing Address
First Line : 5789 FUTURA WAY
Second Line :
City : SANTA ROSA
State : CA
Zip : 95409-4408
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 TAMAL PLZ STE 220
Second Line :
City : CORTE MADERA
State : CA
Zip : 94925-1136
Country : US
Telephone Number : 650-727-0194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 02/07/2026

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