Provider Demographics
NPI:1306908140
Name:RAMAKRISHNA, SUJATHA (MD)
Entity type:Individual
Prefix:MS
First Name:SUJATHA
Middle Name:
Last Name:RAMAKRISHNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 N AIR FRESNO DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1547
Mailing Address - Country:US
Mailing Address - Phone:559-600-6899
Mailing Address - Fax:
Practice Address - Street 1:2719 N AIR FRESNO DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1547
Practice Address - Country:US
Practice Address - Phone:559-600-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC512102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG85882Medicare ID - Type Unspecified