Healthcare Provider Details

I. General information

NPI: 1114773942
Provider Name (Legal Business Name): HARPREET DEOGUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 YOUNG ST
BAKERSFIELD CA
93311-8896
US

IV. Provider business mailing address

14463 DUSTY COYOTE AVE
MORENO VALLEY CA
92555-5759
US

V. Phone/Fax

Practice location:
  • Phone: 661-412-9391
  • Fax:
Mailing address:
  • Phone: 951-486-1935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: