Provider Demographics
NPI:1437551934
Name:SOSA, PAULA KATHLEEN (CADCIII, B0000790420)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:KATHLEEN
Last Name:SOSA
Suffix:
Gender:F
Credentials:CADCIII, B0000790420
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:KATHLEEN
Other - Last Name:CARLISLE RODRIQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADCIII, B0000790420
Mailing Address - Street 1:9500 MALECH ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138
Mailing Address - Country:US
Mailing Address - Phone:408-281-6563
Mailing Address - Fax:408-281-6580
Practice Address - Street 1:9500 MALECH ROAD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138
Practice Address - Country:US
Practice Address - Phone:408-281-6563
Practice Address - Fax:408-281-6580
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)