Healthcare Provider Details

I. General information

NPI: 1790606366
Provider Name (Legal Business Name): ANJANA KUMARI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6882 BRANDY CIR
GRANITE BAY CA
95746-6241
US

IV. Provider business mailing address

6882 BRANDY CIR
GRANITE BAY CA
95746-6241
US

V. Phone/Fax

Practice location:
  • Phone: 669-337-5574
  • Fax: 916-872-1730
Mailing address:
  • Phone: 669-337-5574
  • Fax: 916-872-1730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number7038277740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: