Healthcare Provider Details

I. General information

NPI: 1518891241
Provider Name (Legal Business Name): FELICIA LU PENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUIS CABADA CABADA

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22135 SEVILLA RD APT 43
HAYWARD CA
94541-2865
US

IV. Provider business mailing address

22135 SEVILLA RD APT 43
HAYWARD CA
94541-2865
US

V. Phone/Fax

Practice location:
  • Phone: 510-427-2714
  • Fax: 510-427-2714
Mailing address:
  • Phone: 510-427-2714
  • Fax: 510-427-2714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberC5468730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: