MEDICARE: MRS. LEILA CAROLINE PISHEH MSN, APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95000768	CA

General Provider Information

NPI Number	:	1013319821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEILA CAROLINE PISHEH MSN, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	2020 J ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95811-3120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 FLORIN RD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-1802
Country	:	US
Telephone Number	:	916-341-0575
Fax Number	:	916-498-9040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2014
Last Update Date	:	05/17/2023

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