Provider Demographics
NPI:1598906190
Name:UPPAL, RANJIT S (CAS)
Entity Type:Individual
Prefix:MR
First Name:RANJIT
Middle Name:S
Last Name:UPPAL
Suffix:
Gender:M
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3810
Mailing Address - Country:US
Mailing Address - Phone:916-394-2328
Mailing Address - Fax:916-394-2457
Practice Address - Street 1:2515 48TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3810
Practice Address - Country:US
Practice Address - Phone:916-394-2328
Practice Address - Fax:916-394-2457
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03-085786101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)