Healthcare Provider Details

I. General information

NPI: 1275411167
Provider Name (Legal Business Name): JASLEEN SIDHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11009 IRONTOOTH AVE
BAKERSFIELD CA
93311-8233
US

IV. Provider business mailing address

11009 IRONTOOTH AVE
BAKERSFIELD CA
93311-8233
US

V. Phone/Fax

Practice location:
  • Phone: 661-474-1068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95297099
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9690818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: