Healthcare Provider Details

I. General information

NPI: 1245080944
Provider Name (Legal Business Name): KRATIKA MISHRA MD MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1437
US

IV. Provider business mailing address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1437
US

V. Phone/Fax

Practice location:
  • Phone: 747-210-3343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA204907
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA204907
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: