Healthcare Provider Details

I. General information

NPI: 1487572285
Provider Name (Legal Business Name): KAIRII LITTLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 28TH AVE
OAKLAND CA
94601-1632
US

IV. Provider business mailing address

1451 28TH AVE
OAKLAND CA
94601-1632
US

V. Phone/Fax

Practice location:
  • Phone: 510-261-9191
  • Fax:
Mailing address:
  • Phone: 510-261-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: