Healthcare Provider Details

I. General information

NPI: 1477374635
Provider Name (Legal Business Name): JASMEET KAUR HANJRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARNOLD RD
DUBLIN CA
94568-7724
US

IV. Provider business mailing address

5601 ARNOLD RD
DUBLIN CA
94568-7724
US

V. Phone/Fax

Practice location:
  • Phone: 925-940-1541
  • Fax:
Mailing address:
  • Phone: 631-408-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: