Provider Demographics
NPI:1154680601
Name:RA, KASHA (LAC)
Entity Type:Individual
Prefix:
First Name:KASHA
Middle Name:
Last Name:RA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 N PARK DR UNIT 812
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1877
Mailing Address - Country:US
Mailing Address - Phone:310-488-6077
Mailing Address - Fax:
Practice Address - Street 1:1754 36TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6613
Practice Address - Country:US
Practice Address - Phone:916-572-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist