Healthcare Provider Details

I. General information

NPI: 1326819970
Provider Name (Legal Business Name): OSCAR JOVANI SORIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BRIARFIELD WAY
BELMONT CA
94002-2712
US

IV. Provider business mailing address

1001 SNEATH LN STE 210
SAN BRUNO CA
94066-2349
US

V. Phone/Fax

Practice location:
  • Phone: 650-369-4598
  • Fax: 650-369-4619
Mailing address:
  • Phone: 650-244-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: