Healthcare Provider Details

I. General information

NPI: 1548580384
Provider Name (Legal Business Name): VEDIKA NEHRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

IV. Provider business mailing address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

V. Phone/Fax

Practice location:
  • Phone: 415-237-0377
  • Fax: 415-484-1944
Mailing address:
  • Phone: 415-237-0377
  • Fax: 415-484-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number140501
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number140501
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number140501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: