Provider Demographics
NPI:1356075725
Name:WILLIAMSON, ALEXA DANIELLE
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:DANIELLE
Last Name:WILLIAMSON
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 1:11059 CAMINITO ARCADA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3667
Mailing Address - Country:US
Mailing Address - Phone:480-388-6137
Mailing Address - Fax:
Practice Address - Street 1:135 SAXONY RD
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3791
Practice Address - Country:US
Practice Address - Phone:310-825-9789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1095601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice