Healthcare Provider Details

I. General information

NPI: 1750916177
Provider Name (Legal Business Name): ASSESSMENT AND DEVELOPMENT CENTER OF SACRAMENTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 RIVER PARK DR STE 103
SACRAMENTO CA
95815-4603
US

IV. Provider business mailing address

1555 RIVER PARK DR STE 103
SACRAMENTO CA
95815-4603
US

V. Phone/Fax

Practice location:
  • Phone: 916-692-8837
  • Fax:
Mailing address:
  • Phone: 916-692-8837
  • Fax: 916-200-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SHIBA RAHIMI
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 916-969-7588