MEDICARE: SHIBA RAHIMI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	225C00000X	Rehabilitation Counselor	2012813	CA
3	103TC0700X	Clinical Psychologist	31179	CA

General Provider Information

NPI Number	:	1477801314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIBA RAHIMI

Provider Business Mailing Address
First Line	:	1555 RIVER PARK DR STE 103
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4603
Country	:	US
Telephone Number	:	916-692-8837
Fax Number	:	916-200-3196

Provider Business Practice Location Address
First Line	:	1555 RIVER PARK DR STE 103
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4603
Country	:	US
Telephone Number	:	916-692-8837
Fax Number	:	916-200-3196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	12/19/2025

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Directions to “ SHIBA RAHIMI ” Practice Location

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