Healthcare Provider Details

I. General information

NPI: 1518646850
Provider Name (Legal Business Name): OSAS SANDRA EHIGIEGBA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 ARNOLD DR STE 110
MARTINEZ CA
94553-4189
US

IV. Provider business mailing address

1340 ARNOLD DR STE 110
MARTINEZ CA
94553-4189
US

V. Phone/Fax

Practice location:
  • Phone: 925-387-9808
  • Fax:
Mailing address:
  • Phone: 510-246-7233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95136270
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95031331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: