Prax Medical Ca, PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PRAX MEDICAL CA, PC

Practice address

2108 N St # 10310
Sacramento, CA 95816-5712

Phone

(415) 336-5090

NPI assigned

Jan 14, 2025

Last updated

Jul 23, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Shen, MDNPI 1508826405

Title

Chief Executive Officer

Phone

(512) 779-7276

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Cantos

  • Family Nurse Practitioner
  • Ventura, CA
  • NPI 1114703188
  Medicare reassignment NPD
• Dana Culp, NP

  • Family Nurse Practitioner
  • Truckee, CA
  • NPI 1699213967
  Medicare reassignment NPD
• Mae Pet Fetherlin, FNP

  • Family Nurse Practitioner
  • El Cajon, CA
  • NPI 1336092360
  Medicare reassignment NPD
• Da Som Choi

  • Family Nurse Practitioner
  • Modesto, CA
  • NPI 1407484058
  Medicare reassignment
• Elizabeth Anne Dederick, NP

  • Family Nurse Practitioner
  • Victorville, CA
  • NPI 1619602570
  Medicare reassignment
• Mark Wayne Shen, MD

  • Pediatrics Physician
  • West Lake Hills, TX
  • NPI 1508826405
  Authorized official Same address or phone
• Charlene Campbell Hanson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Francisco, CA
  • NPI 1871181180
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1346051943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N ST # 10310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N ST # 10310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712",
            "telephone_number": "415-336-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAX MEDICAL CA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "512-779-7276",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Prater Jr.
• Sean Prater, M.D.
• Manolis Alexander Pratsinis
• Phyllis Anne Pratt
• Wanda Lee Pratt, LCSW
• Linda Madeleine Prayer, M.A.
• Nancy Preciado
• Teresa Preciado
• Precious Time Inclusion Program LLC
• Precision Cardio Pulmonary, LLC

• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.