Healthcare Provider Details

I. General information

NPI: 1750213203
Provider Name (Legal Business Name): KHALSA FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 W SHAW AVE STE 220
FRESNO CA
93711-3519
US

IV. Provider business mailing address

1690 W SHAW AVE STE 220
FRESNO CA
93711-3519
US

V. Phone/Fax

Practice location:
  • Phone: 559-220-3134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: PRABLEEB KAUR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-220-3134