Provider Demographics
NPI:1376887935
Name:HASHEMI, LADAN P (NP)
Entity Type:Individual
Prefix:MRS
First Name:LADAN
Middle Name:P
Last Name:HASHEMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1860 HOWE AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1098
Mailing Address - Country:US
Mailing Address - Phone:916-569-8484
Mailing Address - Fax:916-256-2214
Practice Address - Street 1:1276 HALYARD DR
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3412
Practice Address - Country:US
Practice Address - Phone:855-354-2242
Practice Address - Fax:916-256-2214
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22603363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEFF: 4/23/13 MARYSVIMedicaid
CAEFF:4/23/13-CITRUS HMedicaid
CAEFF: 4/23/13 NORWOODMedicaid
CAP01284216OtherRAILROAD MEDICARE-DS9933
CAEFF: 4/23/13 55TH STMedicaid
CAEFF: 4/23/13 NORWOODMedicaid
CAEFF: 4/23/13 MARYSVIMedicaid