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General NPI Number Information
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NPI Number | 1407264203
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Entity Type | Individual
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Provider Name | NASRATULLAH WAHIDI MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1325 COTTONWOOD ST
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City | WOODLAND
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State | CA
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Zip | 95695-5131
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Country | US
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Telephone | 859-323-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 WEBSTER ST STE 402
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City | OAKLAND
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State | CA
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Zip | 94609-3149
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Country | US
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Telephone | 844-867-8444
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Fax | 510-858-6613
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.133943
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License Number State | OH
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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 | A146559
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD196684
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License Number State | OR
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