Healthcare Provider Details

I. General information

NPI: 1659659894
Provider Name (Legal Business Name): ERIN ENEIDA SOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 E 12TH ST
OAKLAND CA
94601-3424
US

IV. Provider business mailing address

3301 E 12TH ST
OAKLAND CA
94601-3424
US

V. Phone/Fax

Practice location:
  • Phone: 510-269-9030
  • Fax: 510-269-9031
Mailing address:
  • Phone: 510-269-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: