Provider Demographics
NPI:1447865787
Name:PRASAD, RINKY SAINI (CRNA)
Entity type:Individual
Prefix:
First Name:RINKY
Middle Name:SAINI
Last Name:PRASAD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:RINKY
Other - Middle Name:
Other - Last Name:SAINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10653 CHATFIELD CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4241
Mailing Address - Country:US
Mailing Address - Phone:209-662-2606
Mailing Address - Fax:
Practice Address - Street 1:1800 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6019
Practice Address - Country:US
Practice Address - Phone:209-943-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001495367500000X
CA812672163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse