Healthcare Provider Details

I. General information

NPI: 1235825456
Provider Name (Legal Business Name): SHRISHTI BHATTARAI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 NATIONAL AVE
SAN DIEGO CA
92113-2113
US

IV. Provider business mailing address

3102 MABRY DR
SACRAMENTO CA
95835-2694
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2300
  • Fax:
Mailing address:
  • Phone: 530-204-8533
  • 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 TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A23471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: