Healthcare Provider Details

I. General information

NPI: 1205249760
Provider Name (Legal Business Name): CHRISTINE RAQUIDAN NASOL MA, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE RAQUIDAN MONSALVE NASOL LCAT

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 E 27TH ST
OAKLAND CA
94601-1912
US

IV. Provider business mailing address

2633 E 27TH ST
OAKLAND CA
94601-1912
US

V. Phone/Fax

Practice location:
  • Phone: 510-536-8111
  • Fax:
Mailing address:
  • Phone: 510-536-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License NumberP92560
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: