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NPI Code Detail

MEDICARE: ALEXANDRIA FORD

MEDICARE: ALEXANDRIA FORD
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1902314560
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA FORD
Provider Business Mailing Address
First Line : 2813 PARKVIEW TER
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-1076
Country : US
Telephone Number : 707-471-8943
Fax Number :
Provider Business Practice Location Address
First Line : 150 GLEN COVE MARINA RD E STE 102
Second Line :
City : VALLEJO
State : CA
Zip : 94591-7237
Country : US
Telephone Number : 510-268-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2018
Last Update Date : 12/26/2018

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Directions to “ ALEXANDRIA FORD ” Practice Location

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