Provider Demographics
NPI:1083909113
Name:PRASAD, VINEETA (RN)
Entity Type:Individual
Prefix:MISS
First Name:VINEETA
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 BRANCH CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3809
Mailing Address - Country:US
Mailing Address - Phone:916-596-4239
Mailing Address - Fax:916-596-4241
Practice Address - Street 1:3990 BRANCH CENTER RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3809
Practice Address - Country:US
Practice Address - Phone:916-596-4239
Practice Address - Fax:916-596-4241
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA781171163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse