Healthcare Provider Details

I. General information

NPI: 1396495230
Provider Name (Legal Business Name): SNEHA MADHURI VADDADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST # 1100
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST # 1100
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone: 916-734-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA190072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: