Individual
SAMUEL ISAIAS PENATE VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Mailing address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APCC20443
CA
Other
Enumeration date
11/03/2023
Last updated
11/08/2025
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