Alexandra Bravo Diaz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

96620 Issued in CA

Practice address

818 N Mountain Ave
Upland, CA 91786-4167

Phone

(415) 992-6155

Fax

(650) 360-6913

NPI assigned

Oct 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alexandra Monique Bravo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1922519701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864167",
            "telephone_number": "415-992-6155",
            "fax_number": "650-360-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALEXANDRA",
        "middle_name": "BRAVO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2025-08-18",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "96620",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "BRAVO",
            "middle_name": "MONIQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Devine
• Jane Devries
• DFT Healthcare Group Inc.
• Nachiket Dharmadhikari, LCSW
• Christina Irene Diaz Ickis
• Martha Alejandra Diaz
• Rossana Diaz, LE, CMT, MMP
• Violeta Jazmin Diaz
• Yoseline Diaz, BSW
• Louis Maximilian Dibernardo, MD

• Clinical Social Worker in Upland, CA
• Providers in Upland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.