MEDICARE: RAVEN FORD

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	235Z00000X	Speech-Language Pathologist	21726	CA

General Provider Information

NPI Number	:	1750246575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVEN FORD

Provider Business Mailing Address
First Line	:	1650 CREEKSIDE DR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 CREEKSIDE DR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3400
Country	:	US
Telephone Number	:	916-983-7400
Fax Number	:

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

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

Similar Medicare Providers

1356341606 — DR. CARLOS GABRIEL PEREZ M.D.
Practice Location Address:

1650 CREEKSIDE DR
FOLSOM, CA
95630-3400

Practice Phone: 916-986-4426
Practice Fax: 916-986-4434

1902895113 — DR. BARRY YOUNG MD
Practice Location Address:

1650 CREEKSIDE DR
FOLSOM, CA
95630-3400

Practice Phone: 916-984-7269
Practice Fax: 916-984-7392

1275517062 — DR. ILYA L KHAMISHON M.D.
Practice Location Address:

1650 CREEKSIDE DR STE 170
FOLSOM, CA
95630-3400

Practice Phone: 916-986-4426
Practice Fax: 916-986-4434

1952387953 — DR. MURALI D. ADUSUMALLI M.D.
Practice Location Address:

1650 CREEKSIDE DR
FOLSOM, CA
95630-3400

Practice Phone: 916-986-4426
Practice Fax: 916-986-4434

1164472759 — DR. HEMLATA OSWAL M.D.
Practice Location Address:

1650 CREEKSIDE DRIVE , DEPT. OF PATHOLOGY
FOLSOM, CA
95630-3400

Practice Phone: 916-983-7458
Practice Fax: 916-672-1524

1841245321 — SYLVIA MARX P.A-C
Practice Location Address:

1650 CREEKSIDE DR
FOLSOM, CA
95630-3400

Practice Phone: 916-983-7470
Practice Fax:

Directions to “ RAVEN FORD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.