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NPI Code Detail

MEDICARE: DR. MAISHA MICHELLE CORREIA MD

MEDICARE: DR. MAISHA MICHELLE CORREIA MD
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
12084P0800XPsychiatry PhysicianMRM-1277ID
22084P0800XPsychiatry PhysicianM-12966ID
3390200000XStudent in an Organized Health Care Education/Training ProgramMRM-1277ID
42084P0800XPsychiatry PhysicianC162592CA

General Provider Information

NPI Number : 1831417757
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAISHA MICHELLE CORREIA MD
Provider Business Mailing Address
First Line : 2365 IRON POINT RD STE 210
Second Line :
City : FOLSOM
State : CA
Zip : 95630-8713
Country : US
Telephone Number : 279-258-6718
Fax Number : 916-596-2135
Provider Business Practice Location Address
First Line : 2365 IRON POINT RD STE 210
Second Line :
City : FOLSOM
State : CA
Zip : 95630-8713
Country : US
Telephone Number : 925-282-1778
Fax Number : 415-296-5299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2010
Last Update Date : 01/21/2025

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