Alexandra Marie Rutherford, MS, RN, PHN, AGPCNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95012397 Issued in CA

Practice address

4150 Clement Street
San Francisco, CA 94121-1545

Phone

(415) 221-4810

NPI assigned

May 9, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other names 1

• Alexandra Marie Edmondson Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1285290726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 N San Mateo Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944012794",
            "country_code": "US",
            "telephone_number": "650-425-9408",
            "fax_number": "415-554-0107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Sutter St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941044007",
            "country_code": "US",
            "telephone_number": "833-349-0850 x1050",
            "fax_number": "415-944-4973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3260 Kerner Blvd",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949014840",
            "country_code": "US",
            "telephone_number": "415-448-1500",
            "fax_number": "415-755-2550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3110 Kerner Blvd",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949015411",
            "country_code": "US",
            "telephone_number": "415-448-1500",
            "fax_number": "415-755-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, RN, PHN, AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95012397",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95136326",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "558319",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95012397",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95012397",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "EDMONDSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Rusznak
• Pierrot Rutagarama, MD
• Ceres Rutan
• Robin Ruth
• Jennifer Ruthenburg, M.D.
• Christina Rutherford
• George Williams Rutherford III, MD
• Linda D Ruthruff, PH.D.
• Rachel Lena Rutishauser, PH.D.
• Westley Rutter, ACSW

• Primary Care Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.