Provider Demographics
NPI:1689326571
Name:NISHKIAN, PARKER RICHARD
Entity Type:Individual
Prefix:MR
First Name:PARKER
Middle Name:RICHARD
Last Name:NISHKIAN
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 1:3124 SHELTER COVE LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4654
Mailing Address - Country:US
Mailing Address - Phone:916-206-5022
Mailing Address - Fax:
Practice Address - Street 1:3600 POWER INN RD STE C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3826
Practice Address - Country:US
Practice Address - Phone:916-647-5434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)