Healthcare Provider Details

I. General information

NPI: 1043845480
Provider Name (Legal Business Name): KARINA ALYERIS SOTO ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 DAVIS ST STE 300
SAN LEANDRO CA
94577-6923
US

IV. Provider business mailing address

777 DAVIS ST STE 300
SAN LEANDRO CA
94577-6923
US

V. Phone/Fax

Practice location:
  • Phone: 510-839-3800
  • Fax:
Mailing address:
  • Phone: 510-839-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: