Healthcare Provider Details

I. General information

NPI: 1427865187
Provider Name (Legal Business Name): NAVNEET KAUR BAHIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3109 E WHITMORE AVE
CERES CA
95307-2906
US

IV. Provider business mailing address

3109 E WHITMORE AVE
CERES CA
95307-2906
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-4842
  • Fax: 866-234-5550
Mailing address:
  • Phone: 209-722-4842
  • Fax: 866-234-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95028699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: