Healthcare Provider Details

I. General information

NPI: 1417863010
Provider Name (Legal Business Name): CAROL SACHIKO ENOCHTY LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4849 GERANIUM PL
OAKLAND CA
94619-3036
US

IV. Provider business mailing address

4849 GERANIUM PL
OAKLAND CA
94619-3036
US

V. Phone/Fax

Practice location:
  • Phone: 925-586-9201
  • Fax:
Mailing address:
  • Phone: 925-586-9201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number7813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: