Healthcare Provider Details

I. General information

NPI: 1699623355
Provider Name (Legal Business Name): AMAIYA RIGGINS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GRAND AVE STE 200
OAKLAND CA
94612-3726
US

IV. Provider business mailing address

150 GRAND AVE STE 200
OAKLAND CA
94612-3726
US

V. Phone/Fax

Practice location:
  • Phone: 510-923-1099
  • Fax: 510-903-7509
Mailing address:
  • Phone: 510-923-1099
  • Fax: 510-903-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number752610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: