Healthcare Provider Details

I. General information

NPI: 1215816269
Provider Name (Legal Business Name): JAGJIT K HUNDAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JAN CT STE 150
CHICO CA
95928-4418
US

IV. Provider business mailing address

35 JAN CT STE 150
CHICO CA
95928-4418
US

V. Phone/Fax

Practice location:
  • Phone: 530-899-8853
  • Fax: 530-899-8854
Mailing address:
  • Phone: 530-899-8853
  • Fax: 530-899-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95036633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: