Healthcare Provider Details

I. General information

NPI: 1457948564
Provider Name (Legal Business Name): SHALINI YALAMANCHI, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 MENDOCINO AVE STE 380
SANTA ROSA CA
95403-3612
US

IV. Provider business mailing address

3536 MENDOCINO AVE STE 380
SANTA ROSA CA
95403-3612
US

V. Phone/Fax

Practice location:
  • Phone: 707-575-5353
  • Fax: 707-523-7729
Mailing address:
  • Phone: 707-575-5353
  • Fax: 707-523-7729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHALINI YALAMANCHI
Title or Position: MD/OWNER
Credential: MD
Phone: 707-575-5353