Healthcare Provider Details

I. General information

NPI: 1144141524
Provider Name (Legal Business Name): JASLEEN KAUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 ANDERSON RD STE 10
DAVIS CA
95616-3505
US

IV. Provider business mailing address

8164 KIRKWALL CT
SACRAMENTO CA
95829-1522
US

V. Phone/Fax

Practice location:
  • Phone: 530-758-1122
  • Fax:
Mailing address:
  • Phone: 916-627-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: