Healthcare Provider Details

I. General information

NPI: 1831835057
Provider Name (Legal Business Name): MRS. RESHMI LATA MIZANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS RESHMI PRASAD

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 CAL CENTER DR STE 137
SACRAMENTO CA
95826-3236
US

IV. Provider business mailing address

DEPTLA 22763,PASADENA CA 91185-2763
PASADENA CA
91185-2763
US

V. Phone/Fax

Practice location:
  • Phone: 855-523-4268
  • Fax:
Mailing address:
  • Phone: 866-523-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: