Healthcare Provider Details

I. General information

NPI: 1619432150
Provider Name (Legal Business Name): RAYMUNDO FIGUEROA PEDRAZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 ATLANTIC AVE STE 101
ALAMEDA CA
94501-1188
US

IV. Provider business mailing address

5309 LIVE OAK ST
CUDAHY CA
90201-4422
US

V. Phone/Fax

Practice location:
  • Phone: 818-548-3695
  • Fax:
Mailing address:
  • Phone: 323-559-2813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: