Healthcare Provider Details

I. General information

NPI: 1093620551
Provider Name (Legal Business Name): MEHRI PAZEKY ED.S,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 MISSOURI FLAT RD
PLACERVILLE CA
95667-6816
US

IV. Provider business mailing address

2949 LAREDO DR
ROCKLIN CA
95765-5636
US

V. Phone/Fax

Practice location:
  • Phone: 530-622-5081
  • Fax:
Mailing address:
  • Phone: 949-600-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260137299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: