Healthcare Provider Details

I. General information

NPI: 1811670003
Provider Name (Legal Business Name): PARVINDER KAUR SIDHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PARVINDER KAUR JANGLE

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 S BARTON AVE
FRESNO CA
93702-2985
US

IV. Provider business mailing address

1160 MINARETS AVE
CLOVIS CA
93611-0316
US

V. Phone/Fax

Practice location:
  • Phone: 559-860-4422
  • Fax:
Mailing address:
  • Phone: 559-444-3443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN734526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: