Healthcare Provider Details

I. General information

NPI: 1558270165
Provider Name (Legal Business Name): SHANIA SHALVI KUMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3331 POWER INN RD
SACRAMENTO CA
95826-3889
US

IV. Provider business mailing address

1080 PURDUE CT
DIXON CA
95620-9324
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-1183
  • Fax: 918-875-6904
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number742854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: