Healthcare Provider Details

I. General information

NPI: 1841106978
Provider Name (Legal Business Name): DIEGO RIVERA-GARCIA
Entity Type: Individual
Gender: Male
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

3031 E 18TH ST
OAKLAND CA
94601-2457
US

IV. Provider business mailing address

7550 SUNKIST DR
OAKLAND CA
94605-3023
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-5236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number26B02C5FF2
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: