Healthcare Provider Details

I. General information

NPI: 1598779126
Provider Name (Legal Business Name): VEMIREDDI SRIKRISHNA PRASAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1899 EAST ROSEVILLE PARK WAY #150
ROSEVILLE CA
95661
US

IV. Provider business mailing address

3017 DOUGLAS BLVD STE 300
ROSEVILLE CA
95661-3850
US

V. Phone/Fax

Practice location:
  • Phone: 916-305-4349
  • Fax: 916-581-8736
Mailing address:
  • Phone: 916-724-2642
  • Fax: 916-724-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA38801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: