Healthcare Provider Details

I. General information

NPI: 1306769344
Provider Name (Legal Business Name): RONALD ALCAYDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4053 LONE TREE WAY
ANTIOCH CA
94531-6200
US

IV. Provider business mailing address

4053 LONE TREE WAY
ANTIOCH CA
94531-6200
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-1844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number32308682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: