Provider Demographics
NPI:1992173660
Name:SCHULTHESS, ALEXANDRA E (ND, BCDNM,CFMP)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:E
Last Name:SCHULTHESS
Suffix:
Gender:F
Credentials:ND, BCDNM,CFMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17710 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95006-8607
Mailing Address - Country:US
Mailing Address - Phone:669-225-3173
Mailing Address - Fax:
Practice Address - Street 1:17710 BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:BOULDER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95006-8607
Practice Address - Country:US
Practice Address - Phone:669-225-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
NV06766202D00000X
CA06766202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No175F00000XOther Service ProvidersNaturopath