Healthcare Provider Details

I. General information

NPI: 1316747728
Provider Name (Legal Business Name): ALEXIS R OGDIE MA EDUCATION
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AUGHINBAUGH WAY
ALAMEDA CA
94502-7451
US

IV. Provider business mailing address

200 AUGHINBAUGH WAY
ALAMEDA CA
94502-7451
US

V. Phone/Fax

Practice location:
  • Phone: 510-748-4010
  • Fax:
Mailing address:
  • Phone: 510-748-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberB74E4E1A75
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: