Healthcare Provider Details

I. General information

NPI: 1487193488
Provider Name (Legal Business Name): PAVNEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HAGGIN OAKS BLVD STE 202
BAKERSFIELD CA
93311-1333
US

IV. Provider business mailing address

PO BOX 9854
BAKERSFIELD CA
93389-1854
US

V. Phone/Fax

Practice location:
  • Phone: 661-735-3887
  • Fax:
Mailing address:
  • Phone: 661-304-8639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032315
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95111066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: