Active NPI
Sofia Siena Van Sickle
- Professional Counselor
- Hayward, CA
National Provider Identifier
1073249116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17761
- Practice address
- 22505 Woodroe Ave
Hayward, CA 94541-3410 - Phone
- (510) 613-0330
- NPI assigned
- Jul 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 17761 | CA | Primary |
Addresses
Primary practice location
22505 Woodroe Ave
Hayward, CA 94541-3410
Mailing address
22505 Woodroe Ave
Fairview, CA 94541-3410
Phone (510) 537-1688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1073249116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22505 WOODROE AVE",
"city": "FAIRVIEW",
"state": "CA",
"postal_code": "945413410",
"telephone_number": "510-537-1688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22505 WOODROE AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945413410",
"telephone_number": "510-613-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN SICKLE",
"first_name": "SOFIA",
"middle_name": "SIENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-30",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "17761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.