Doctor Name: | MRS. LEILA CAROLINE PISHEH |
NPI Number: | 1013319821 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 95000768 |
Business Practice Address: | 3001 Douglas Blvd Suite 150 Roseville, CA - 956613851 |
Business Phone Number: | 9162419844 |
Business Fax Number: | |
Mailing Address: | 3001 Douglas Blvd, ROSEVILLE |
State: | CA |
Postal Code: | 956613851 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/24/2014 |
NPI Last Update Date: | 11/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95000768 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |