Healthcare Provider Details

I. General information

NPI: 1568370732
Provider Name (Legal Business Name): JAGBIR KANG, LICENSED MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 J ST UNIT 2101
FREMONT CA
94536-8006
US

IV. Provider business mailing address

160 J ST UNIT 2101
FREMONT CA
94536-8006
US

V. Phone/Fax

Practice location:
  • Phone: 510-766-1418
  • Fax:
Mailing address:
  • Phone: 510-766-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAGBIR KAUR KANG
Title or Position: PRESIDENT
Credential: LMFT
Phone: 510-766-1418