Healthcare Provider Details

I. General information

NPI: 1982571246
Provider Name (Legal Business Name): RANNY KEOPRADABSY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 MADISON AVE STE 7
CARMICHAEL CA
95608-0645
US

IV. Provider business mailing address

6600 MADISON AVE STE 7
CARMICHAEL CA
95608-0645
US

V. Phone/Fax

Practice location:
  • Phone: 916-965-1111
  • Fax:
Mailing address:
  • Phone: 916-965-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95327547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: