Provider Demographics
NPI:1053033357
Name:SAHOTA, SAPNA
Entity type:Individual
Prefix:
First Name:SAPNA
Middle Name:
Last Name:SAHOTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 LAKE VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6285
Mailing Address - Country:US
Mailing Address - Phone:916-934-3503
Mailing Address - Fax:
Practice Address - Street 1:6450 PONY EXPRESS TRL
Practice Address - Street 2:
Practice Address - City:POLLOCK PINES
Practice Address - State:CA
Practice Address - Zip Code:95726-9601
Practice Address - Country:US
Practice Address - Phone:530-647-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist