Provider Demographics
NPI:1235752312
Name:RAJ, SAVINESH
Entity Type:Individual
Prefix:
First Name:SAVINESH
Middle Name:
Last Name:RAJ
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 1:8950 CAL CENTER DR STE 160
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3225
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8950 CAL CENTER DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3259
Practice Address - Country:US
Practice Address - Phone:916-426-0888
Practice Address - Fax:916-376-7467
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2023-08-07
Deactivation Date:2020-11-18
Deactivation Code:
Reactivation Date:2023-08-07
Provider Licenses
StateLicense IDTaxonomies
CA695470164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse