Healthcare Provider Details

I. General information

NPI: 1659765576
Provider Name (Legal Business Name): ANJANI K AMLADI-GOMEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANJANI K AMLADI MD

II. Dates (important events)

Enumeration Date: 03/28/2015
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 IRON POINT RD
FOLSOM CA
95630-8707
US

IV. Provider business mailing address

1800 HARRISON ST, 7TH FL
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 916-817-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA145048
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA145048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: