Healthcare Provider Details

I. General information

NPI: 1083364186
Provider Name (Legal Business Name): LIANNA DAMALI PRELLA ROBLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIANNA DAMALI PRELLA FOSTER-BEY MD

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

8990 GULFPORT WAY
SACRAMENTO CA
95826-2138
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2011
  • Fax:
Mailing address:
  • Phone: 571-334-9145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA190850
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA190850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: