Provider Demographics
NPI:1982976551
Name:MURALLO, ALEXANDRIA V (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:V
Last Name:MURALLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MARKET ST STE 377
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3009
Mailing Address - Country:US
Mailing Address - Phone:628-220-0500
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 377
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3009
Practice Address - Country:US
Practice Address - Phone:628-220-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-29
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20475103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA273848572OtherFEIN