ALEXANDRA CROCKETT (NPI# 1467865170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467865170 |
| Entity Type | Individual |
| Full Name | ALEXANDRA CROCKETT |
| Credential | PSYD |
| Practice Address |
710 S Broadway Ste 300 Walnut Creek CA 94596-5229 |
| Mailing Address |
512 43rd St Richmond CA 94805-2354 |
| Practice Telephone | 9252954145 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY30646 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
710 S BROADWAY STE 300 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336206721 | Stewart Proctor | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2007-01-03 |
| 1871124222 | Stephanie Gade | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2020-02-03 |
| 1245879725 | Jamie Ashley Williams | Social Worker | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2019-12-31 |
| 1750928354 | Lisa Michelle Walker | Pharmacist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2019-12-03 |
| 1700368974 | Lauren Ellis | Marriage & Family Therapist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2018-09-04 |
| 1659898484 | Anne Rachel Serrano Guijo | Registered Nurse | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2017-08-23 |
| 1225581804 | Shelby Karoline Smith | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2016-07-29 |
| 1225308711 | Matthew Terry Haynes | Social Worker | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2011-12-30 |
| 1730365248 | Catherine Fan Dionisio | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2008-01-15 |
| 1396891651 | Jason Allen Spenser | Social Worker | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2007-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427678127 | Danielle G Dollinger | Psychologist | 55 Cora Ct, Walnut Creek, CA 94597-6803 | 2020-04-22 |
| 1972138287 | Center for Modern Therapy LLC | Psychologist | 1600 S Main St Ste 180, Walnut Creek, CA 94596-8809 | 2020-03-06 |
| 1265907141 | Kind Psychological and Behavioral Services, Inc. | Psychologist | 100 Rose Street, Walnut Creek, CA 94595-1341 | 2018-10-08 |
| 1457866352 | Jonathan Henry Feinberg | Psychologist | 1600 S Main St Ste 177, Walnut Creek, CA 94596-8813 | 2017-12-13 |
| 1194274910 | Allan H. Solomon Ph.d. Inc. | Psychologist | 1200 Mt. Diablo Blvd., Ste. 406, Walnut Creek, CA 94596-4890 | 2016-09-22 |
| 1952789562 | Jennifer Paige Petersen | Psychologist | 39 Quail Ct Ste 205, Walnut Creek, CA 94596-5570 | 2015-05-14 |
| 1457791006 | Ellena Fickett Chen | Psychologist | 700 Ygnacio Valley Rd Ste 320, Walnut Creek, CA 94596-3838 | 2013-06-27 |
| 1649521592 | Courtney Keene Viscomi | Psychologist | 100 Rose St, Walnut Creek, CA 94595-1341 | 2012-10-01 |
| 1518285675 | Larissa D. Terry | Psychologist | 891 Holly Hill Dr, Walnut Creek, CA 94596-6252 | 2010-05-12 |
| 1518197284 | Lisa Johnson Wright | Psychologist | 935 Avondale Ct, Walnut Creek, CA 94596-6030 | 2009-07-16 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
Please comment or provide details below to improve the information on ALEXANDRA CROCKETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.