Provider Demographics
NPI:1942575303
Name:PRAKASH, NEHA (MD)
Entity Type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:PRAKASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 C ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3300
Mailing Address - Country:US
Mailing Address - Phone:916-734-6111
Mailing Address - Fax:916-442-5702
Practice Address - Street 1:3301 C ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3300
Practice Address - Country:US
Practice Address - Phone:916-734-6111
Practice Address - Fax:916-442-5702
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126791207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology