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General NPI Number Information
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NPI Number | 1346051943
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Entity Type | Organization
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Legal Business Name | PRAX MEDICAL CA, PC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 2108 N ST # 10310
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 415-336-5090
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST # 10310
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARK SHEN
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Credential | MD
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Telephone | 512-779-7276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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