Provider Demographics
NPI:1568286722
Name:PRASAD, NARENDRA NONE
Entity type:Individual
Prefix:MR
First Name:NARENDRA
Middle Name:NONE
Last Name:PRASAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 PHEASANT HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4626
Mailing Address - Country:US
Mailing Address - Phone:916-214-4916
Mailing Address - Fax:
Practice Address - Street 1:2415 PHEASANT HOLLOW DR
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-4626
Practice Address - Country:US
Practice Address - Phone:916-214-4916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide