Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 29275 | CA |
N | 103TC0700X | Clinical Psychologist | 29275 | CA |
Y | 103TR0400X | Rehabilitation Psychologist | 29275 | CA |
NPI | 1023507084 |
---|---|
Provider Name | Dr. Alexandra Jouk |
First Address | San Francisco, CA 94116-1499 |
Second Address | San Francisco, CA 94116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2018 |
Last Update Date | 02/07/2018 |