Basic Information
| Provider Information | |||||||||
| NPI: | 1104116250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OROZCO LOZA | ||||||||
| FirstName: | SANDRA | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1493 | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950091493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624135156 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3010 COLBY ST STE 221 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947052056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109229757 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2011 | ||||||||
| LastUpdateDate: | 05/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 93258 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.