Provider Demographics
NPI:1902586209
Name:RIOS, SONNY RAY VICENTE
Entity type:Individual
Prefix:
First Name:SONNY
Middle Name:RAY VICENTE
Last Name:RIOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PERALTA ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-1926
Mailing Address - Country:US
Mailing Address - Phone:510-773-1909
Mailing Address - Fax:
Practice Address - Street 1:920 PERALTA ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-1926
Practice Address - Country:US
Practice Address - Phone:510-773-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker