Healthcare Provider Details

I. General information

NPI: 1316853443
Provider Name (Legal Business Name): ROSANA COVARRUBIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 53RD AVE
OAKLAND CA
94601-5728
US

IV. Provider business mailing address

1325 53RD AVE
OAKLAND CA
94601-5728
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-2178
  • Fax:
Mailing address:
  • Phone: 831-245-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberF57619965D
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: