Healthcare Provider Details

I. General information

NPI: 1699639005
Provider Name (Legal Business Name): EASTBAY HEALTHCARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SADDLEHORN CT
PITTSBURG CA
94565-2471
US

IV. Provider business mailing address

38 BRANDING IRON CT
OAKLEY CA
94561-4405
US

V. Phone/Fax

Practice location:
  • Phone: 925-477-7320
  • Fax:
Mailing address:
  • Phone: 925-477-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY EMEKA NZENWOSU
Title or Position: PRESIDENT
Credential: SJD
Phone: 925-477-7320