Individual provider Active NPI

Sowmya Manjari Siddenthi, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Redding, CA
National Provider Identifier
1669227187
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PTL17204 Issued in CA
Practice address
1100 Butte Street
Attn: Internal Medicine Residency Program
Redding, CA 96001
Phone
(530) 244-5400
Fax
(530) 244-5494
NPI assigned
Apr 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PTL17204 CA Primary

Addresses

Primary practice location

1100 Butte Street
Attn: Internal Medicine Residency Program
Redding, CA 96001

Mailing address

1100 Butte Street
Attn: Internal Medicine Residency Program
Redding, CA 96001
Phone (530) 244-5400

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 Medicine

State licenses

LicenseStateTypeSpecialty
PTL17204CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1669227187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BUTTE STREET",
            "address_2": "ATTN: INTERNAL MEDICINE RESIDENCY PROGRAM",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-244-5400",
            "fax_number": "530-244-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BUTTE STREET",
            "address_2": "ATTN: INTERNAL MEDICINE RESIDENCY PROGRAM",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-244-5400",
            "fax_number": "530-244-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDENTHI",
        "first_name": "SOWMYA MANJARI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PTL17204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.