Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexandra Alabata Ingram, PA

Individual provider Physician Assistant · NPI 1063761500

Alexandra Alabata Ingram, PA is a Physician Assistant in Walnut Creek, California. Qualified in 2012, 14 years ago. Practices with Golden State Dermatology Associates, Inc, a 119-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Alabama and Florida.

Years since qualifying
14
Licensed in
AL, FL
In the registry since
2012
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

355 Lennon Ln Ste 295
Walnut Creek, CA 94598
Phone: (925) 357-9786
Fax: (925) 217-7956
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8573 County Road 64, Daphne, AL 36526-8706 — (251) 621-2244

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Physician Assistant Taxonomy 363A00000X · Licence PA1466 (AL)
Physician Assistant Taxonomy 363A00000X · Licence PA.1466 (AL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA9106852 (FL)

Record details

NPI number1063761500
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 30, 2012
Last updated in NPPESNovember 26, 2024
Certification dateNovember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Golden State Dermatology Associates, Inc. — 119 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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