Healthcare Provider Details

I. General information

NPI: 1811780950
Provider Name (Legal Business Name): SHENG LINDA VANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 EUREKA RD STE 150A
ROSEVILLE CA
95661-7777
US

IV. Provider business mailing address

7000 SANTAREM CT
ELK GROVE CA
95757-5907
US

V. Phone/Fax

Practice location:
  • Phone: 916-746-7235
  • Fax:
Mailing address:
  • Phone: 714-851-7274
  • Fax: 714-851-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: