Provider Demographics
NPI:1265803126
Name:ROUNDS, ALEXANDRA (LM, BS, CLD,CPD, CBC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ROUNDS
Suffix:
Gender:F
Credentials:LM, BS, CLD,CPD, CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-7747
Mailing Address - Country:US
Mailing Address - Phone:707-391-9353
Mailing Address - Fax:
Practice Address - Street 1:205 W CLAY ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5452
Practice Address - Country:US
Practice Address - Phone:707-391-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
CA591176B00000X
L-305639174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN