Provider Demographics
NPI:1760815476
Name:SCHULTZ, ALEXANDRA NOEMI (MS, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:NOEMI
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20317 WISTERIA ST APT 5
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4138
Mailing Address - Country:US
Mailing Address - Phone:510-365-0843
Mailing Address - Fax:
Practice Address - Street 1:20317 WISTERIA ST APT 5
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4138
Practice Address - Country:US
Practice Address - Phone:510-365-0843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist