Healthcare Provider Details

I. General information

NPI: 1023453255
Provider Name (Legal Business Name): DEEPTHI CHERIAN CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEEPTHI CHERIAN MD

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 CAPITOL AVE
SACRAMENTO CA
95816-6039
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 916-887-0104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA165903
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: