Healthcare Provider Details

I. General information

NPI: 1487902128
Provider Name (Legal Business Name): LATIFA NIAZI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 FRANKLIN BLVD STE K
SACRAMENTO CA
95820-4717
US

IV. Provider business mailing address

1860 HOWE AVE STE 445
SACRAMENTO CA
95825-1073
US

V. Phone/Fax

Practice location:
  • Phone: 916-454-2345
  • Fax:
Mailing address:
  • Phone: 916-454-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number815640
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95032991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: