Healthcare Provider Details

I. General information

NPI: 1619540713
Provider Name (Legal Business Name): SACHIKO QUIDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1466 LINCOLN AVE
SAN RAFAEL CA
94901-2021
US

IV. Provider business mailing address

1460 CALIFORNIA ST
BERKELEY CA
94703-1023
US

V. Phone/Fax

Practice location:
  • Phone: 415-526-8008
  • Fax: 415-457-0849
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number127428
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20342
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: