Healthcare Provider Details

I. General information

NPI: 1649188178
Provider Name (Legal Business Name): AMRITPAL KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

494 BLOSSOM WAY
CHERRYLAND CA
94541-1948
US

IV. Provider business mailing address

21348 MONTGOMERY AVE
CHERRYLAND CA
94541-2080
US

V. Phone/Fax

Practice location:
  • Phone: 510-582-7676
  • Fax: 510-582-9080
Mailing address:
  • Phone: 510-605-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number739293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: