Provider Demographics
NPI:1962770230
Name:SITAULA, SIMA (NP)
Entity type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:SITAULA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SIMA
Other - Middle Name:
Other - Last Name:SAPKOTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:PHYSICIAN SUPPORT SERVICES
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3346
Practice Address - Fax:916-733-3320
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX735478363LF0000X
CA23812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01055785OtherRR MEDICARE
TX1962770230OtherBLUE CROSS BLUE SHIELD
TX300901101Medicaid
TX1962770230OtherBLUE CROSS BLUE SHIELD