Healthcare Provider Details

I. General information

NPI: 1548192461
Provider Name (Legal Business Name): SANDEEP SINGH SRAN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3874 JESSE LN
CLOVIS CA
93619-6944
US

IV. Provider business mailing address

3874 JESSE LN
CLOVIS CA
93619-6944
US

V. Phone/Fax

Practice location:
  • Phone: 559-257-8650
  • Fax:
Mailing address:
  • Phone: 559-257-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: