Active NPI
Eillen Carolina Sosa, SLD
- Optician
- Oakland, CA
National Provider Identifier
1336492685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- D7662
- Practice address
- 1940 Fruitvale Ave
Suite 6
Oakland, CA 94601-2413 - Phone
- (510) 731-6976
- Fax
- (510) 698-8744
- NPI assigned
- Oct 24, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | D7662 | CA | Primary |
Addresses
Primary practice location
1940 Fruitvale Ave
Suite 6
Oakland, CA 94601-2413
Mailing address
1940 Fruitvale Ave
Suite 6
Oakland, CA 94601-2413
Phone (510) 731-6976
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7662 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1336492685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 FRUITVALE AVE",
"address_2": "SUITE 6",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012413",
"telephone_number": "510-731-6976",
"fax_number": "510-698-8744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 FRUITVALE AVE",
"address_2": "SUITE 6",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012413",
"telephone_number": "510-731-6976",
"fax_number": "510-698-8744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOSA",
"first_name": "EILLEN",
"middle_name": "CAROLINA",
"credential": "SLD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "D7662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.