MEDICARE: SHREY NINAD PATEL MD

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	2084P0800X	Psychiatry Physician	197825	CA

General Provider Information

NPI Number	:	1861133118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHREY NINAD PATEL MD

Provider Business Mailing Address
First Line	:	2448 GUERNEVILLE RD STE 800
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-7228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 GUERNEVILLE RD STE 800
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-7228
Country	:	US
Telephone Number	:	707-772-7522
Fax Number	:	707-736-7254

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

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	06/03/2026

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