Individual
ALEXANDRA RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
365 KUCK LN, PETALUMA, CA 94952-9606
(707) 795-6954
Mailing address
365 KUCK LN, PETALUMA, CA 94952-9606
(707) 795-6954
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
07/21/2014
Last updated
09/29/2025
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