Healthcare Provider Details

I. General information

NPI: 1356026785
Provider Name (Legal Business Name): RANEETA AJESHNI SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 ARDEN WAY
SACRAMENTO CA
95825-2015
US

IV. Provider business mailing address

3208 VILLAGIO CT
MODESTO CA
95355-9009
US

V. Phone/Fax

Practice location:
  • Phone: 916-973-5000
  • Fax:
Mailing address:
  • Phone: 209-614-0551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number86566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: