Provider Demographics
NPI:1578906723
Name:NARSANA, NIYATI (MD)
Entity Type:Individual
Prefix:
First Name:NIYATI
Middle Name:
Last Name:NARSANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIYATI
Other - Middle Name:KUNAL
Other - Last Name:JAKHARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4150 V ST # G500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-0151
Mailing Address - Fax:
Practice Address - Street 1:4150 V ST # G500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-0151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172652207RI0200X
NC2019-01513207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty