Healthcare Provider Details

I. General information

NPI: 1861205304
Provider Name (Legal Business Name): RICARDA SAWATZKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2666 CAMINO LENADA
OAKLAND CA
94611-3004
US

IV. Provider business mailing address

2666 CAMINO LENADA
OAKLAND CA
94611-3004
US

V. Phone/Fax

Practice location:
  • Phone: 510-603-0123
  • Fax:
Mailing address:
  • Phone: 510-603-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033769
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95324264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: