Provider Demographics
NPI:1699099382
Name:WEIL, ALEXANDER MAXWELL
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:MAXWELL
Last Name:WEIL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 SHOTWELL ST # B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4016
Mailing Address - Country:US
Mailing Address - Phone:415-810-1221
Mailing Address - Fax:
Practice Address - Street 1:1012 SHOTWELL ST # B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4016
Practice Address - Country:US
Practice Address - Phone:415-810-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88232106H00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker