Healthcare Provider Details

I. General information

NPI: 1811701410
Provider Name (Legal Business Name): NAVROOP KAUR KHAHERA RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ALLEN STREET SUITE B
MARTINEZ CA
94533
US

IV. Provider business mailing address

25 ALLEN ST SUITE B
MARTINEZ CA
94533
US

V. Phone/Fax

Practice location:
  • Phone: 888-678-7277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number95405014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: