Healthcare Provider Details

I. General information

NPI: 1386558930
Provider Name (Legal Business Name): GURCHARANJIT KAUR NURSE PRACTITIONER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 OMAHA CT
DIXON CA
95620-3862
US

IV. Provider business mailing address

1585 OMAHA CT
DIXON CA
95620-3862
US

V. Phone/Fax

Practice location:
  • Phone: 669-900-5721
  • Fax:
Mailing address:
  • Phone: 669-900-5721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: GURCHARANJIT KAUR
Title or Position: OWNER
Credential: NP
Phone: 669-900-5721