Provider Demographics
NPI:1447694542
Name:VORONINA, KSENIA (MD)
Entity type:Individual
Prefix:
First Name:KSENIA
Middle Name:
Last Name:VORONINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KSENIA
Other - Middle Name:
Other - Last Name:SNIEGOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 GLENN DR STE 235
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3193
Mailing Address - Country:US
Mailing Address - Phone:916-209-0533
Mailing Address - Fax:916-209-4056
Practice Address - Street 1:950 GLENN DR STE 235
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3193
Practice Address - Country:US
Practice Address - Phone:916-209-0533
Practice Address - Fax:916-209-4056
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1551502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry