Provider Demographics
NPI:1770796724
Name:D'AMICO, ALEXANDER (ND)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:D'AMICO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:DR
Other - First Name:SANDRO
Other - Middle Name:
Other - Last Name:D'AMICO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:1449 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5008
Mailing Address - Country:US
Mailing Address - Phone:530-823-1335
Mailing Address - Fax:530-885-3249
Practice Address - Street 1:1449 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5008
Practice Address - Country:US
Practice Address - Phone:530-823-1335
Practice Address - Fax:530-885-3249
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-22175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath