Healthcare Provider Details

I. General information

NPI: 1235033069
Provider Name (Legal Business Name): SONIA DE LOS ANGELES AVALOS-REGIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 FAIRMONT DR
CASTRO VALLEY CA
94578-1001
US

IV. Provider business mailing address

2414 38TH AVE
OAKLAND CA
94601-3804
US

V. Phone/Fax

Practice location:
  • Phone: 510-895-5502
  • Fax:
Mailing address:
  • Phone: 510-325-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number750313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: