Healthcare Provider Details

I. General information

NPI: 1881578482
Provider Name (Legal Business Name): PREETI GHUMAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 22ND ST
SACRAMENTO CA
95816-4907
US

IV. Provider business mailing address

1011 22ND ST
SACRAMENTO CA
95816-4907
US

V. Phone/Fax

Practice location:
  • Phone: 916-284-1416
  • Fax:
Mailing address:
  • Phone: 530-844-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: