Healthcare Provider Details
I. General information
NPI: 1174451595
Provider Name (Legal Business Name): HEAVEN BACHAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/13/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5445 LAUREL HILLS DR
SACRAMENTO CA
95841-3105
US
IV. Provider business mailing address
5445 LAUREL HILLS DR
SACRAMENTO CA
95841-3105
US
V. Phone/Fax
- Phone: 916-609-5100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: