Healthcare Provider Details

I. General information

NPI: 1437551934
Provider Name (Legal Business Name): PAULA KATHLEEN SOSA ACSW 135233
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA KATHLEEN CARLISLE-RODRIQUEZ ACSW 135233

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 LENZEN AVE FL 3
SAN JOSE CA
95126-2737
US

IV. Provider business mailing address

976 LENZEN AVE FL 3
SAN JOSE CA
95126-2737
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-2737
  • Fax:
Mailing address:
  • Phone: 408-885-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADCIII-B0000790420
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW135233
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberACSW135233
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberCADCIII-B0000790420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: