# LIFESPARK HEALTH AND WELLNESS NURSING PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063214179
- **Authorized official:** RAMNEEK KAHLON (PRESIDENT & CEO)
- **Authorized official phone:** (916) 949-1258

## Contact information

- **Practice address:** 130 DIAMOND CREEK PL STE 100, ROSEVILLE, CA 95747-7592
- **Practice address phone:** (916) 949-1258
- **Mailing address:** 1253 VISTA VERDE DR, ROSEVILLE, CA 95747-9656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2025
- **Last updated:** 03/27/2025