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General NPI Number Information
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NPI Number | 1346402443
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Entity Type | Individual
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Provider Name | ROSHANAK RAMEZANI MD, MS
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 2100 POWELL ST STE 400
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City | EMERYVILLE
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State | CA
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Zip | 94608-1872
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Country | US
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Telephone | 510-851-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 CUMMINS DR STE D
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City | MODESTO
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State | CA
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Zip | 95358-6411
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Country | US
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Telephone | 510-900-3125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD180681
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18920
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | A110796
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 265095-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A110796
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License Number State | CA
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