Healthcare Provider Details

I. General information

NPI: 1417732421
Provider Name (Legal Business Name): SPERANZA ACOSTA GONZALEZ DE PAGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 LLEWELLYN AVE
CAMPBELL CA
95008-1940
US

IV. Provider business mailing address

400 ESTUDILLO AVE STE 100
SAN LEANDRO CA
94577-4962
US

V. Phone/Fax

Practice location:
  • Phone: 408-698-3436
  • Fax:
Mailing address:
  • Phone: 510-924-0548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139707
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: