Healthcare Provider Details

I. General information

NPI: 1780259853
Provider Name (Legal Business Name): SAMITA CHANDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 E BIDWELL ST
FOLSOM CA
95630-6453
US

IV. Provider business mailing address

349 E AVENUE K6 STE A
LANCASTER CA
93535-4548
US

V. Phone/Fax

Practice location:
  • Phone: 916-473-2235
  • Fax:
Mailing address:
  • Phone: 661-723-4260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA198357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: