Healthcare Provider Details

I. General information

NPI: 1669759148
Provider Name (Legal Business Name): NEGGY RISMANCHI M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 3700
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 3700
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7127
  • Fax:
Mailing address:
  • Phone: 916-734-7127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA118427
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberA118427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: