Provider Demographics
NPI:1104718014
Name:BORDEN, ALEXIS (NCMA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 40TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-3609
Mailing Address - Country:US
Mailing Address - Phone:916-452-1068
Mailing Address - Fax:916-469-9415
Practice Address - Street 1:3647 40TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-3609
Practice Address - Country:US
Practice Address - Phone:916-452-1068
Practice Address - Fax:916-469-9415
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1209207363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical