Healthcare Provider Details

I. General information

NPI: 1841714128
Provider Name (Legal Business Name): ISELA SAHAGUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date: 08/27/2019
Reactivation Date: 09/07/2019

III. Provider practice location address

11 EMBARCADERO W STE 136
OAKLAND CA
94607-4500
US

IV. Provider business mailing address

PO BOX 5715
BERKELEY CA
94705-0715
US

V. Phone/Fax

Practice location:
  • Phone: 510-467-4250
  • Fax:
Mailing address:
  • Phone: 510-467-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number134246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: