Healthcare Provider Details

I. General information

NPI: 1689458556
Provider Name (Legal Business Name): KULJEET KAUR SANGHERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 E 6TH ST
MADERA CA
93638-3631
US

IV. Provider business mailing address

344 E 6TH ST
MADERA CA
93638-3631
US

V. Phone/Fax

Practice location:
  • Phone: 595-664-4000
  • Fax: 559-675-5224
Mailing address:
  • Phone: 595-664-4000
  • Fax: 559-675-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95251220
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: