Provider Demographics
NPI:1639490477
Name:MISHRA, NIKITA V (MD PHD)
Entity type:Individual
Prefix:DR
First Name:NIKITA
Middle Name:V
Last Name:MISHRA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:DR
Other - First Name:NIKITA
Other - Middle Name:AJIT
Other - Last Name:CHAUDHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:6091 EDGEHILL DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5475
Mailing Address - Country:US
Mailing Address - Phone:512-983-8809
Mailing Address - Fax:
Practice Address - Street 1:77 CADILLAC DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5453
Practice Address - Country:US
Practice Address - Phone:512-983-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185906207VX0000X, 207VG0400X
VA0101256550207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VVE279AMedicare PIN
P01412940Medicare PIN