Healthcare Provider Details

I. General information

NPI: 1285922898
Provider Name (Legal Business Name): JASWINDER SRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2011
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 S 8TH ST
KERMAN CA
93630-1803
US

IV. Provider business mailing address

PO BOX 737
SAN JOAQUIN CA
93660-0737
US

V. Phone/Fax

Practice location:
  • Phone: 559-693-2462
  • Fax: 559-693-4382
Mailing address:
  • Phone: 559-693-2462
  • Fax: 559-693-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA21626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: