Healthcare Provider Details

I. General information

NPI: 1710683305
Provider Name (Legal Business Name): HARSIMRANJIT KAUR SANDHU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 FRESNO ST
FRESNO CA
93721-1304
US

IV. Provider business mailing address

PO BOX 889442
LOS ANGELES CA
90088-9442
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-4980
  • Fax: 559-459-4999
Mailing address:
  • Phone: 559-603-7372
  • Fax: 559-451-3661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95023246
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95023246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: