Provider Demographics
NPI:1316715741
Name:BADESHA, RAMAN KAUR
Entity type:Individual
Prefix:
First Name:RAMAN
Middle Name:KAUR
Last Name:BADESHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7073 CASTLE ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8661
Mailing Address - Country:US
Mailing Address - Phone:530-680-7838
Mailing Address - Fax:
Practice Address - Street 1:7073 CASTLE ROCK WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8661
Practice Address - Country:US
Practice Address - Phone:530-680-7838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily