Active NPI
Heena Sudra, PHARM.D
- Pharmacist
- Elk Grove, CA
National Provider Identifier
1124365119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 67985
- Practice address
- 7299 Laguna Blvd
Elk Grove, CA 95758-5059 - Phone
- (916) 691-4412
- NPI assigned
- Jan 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 67985 | CA | Primary |
Addresses
Primary practice location
7299 Laguna Blvd
Elk Grove, CA 95758-5059
Mailing address
14735 Wyandotte St
Van Nuys, CA 91405-1822
Phone (818) 430-9142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 67985 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1124365119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14735 WYANDOTTE ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051822",
"telephone_number": "818-430-9142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7299 LAGUNA BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957585059",
"telephone_number": "916-691-4412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDRA",
"first_name": "HEENA",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-10",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 67985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.