Healthcare Provider Details

I. General information

NPI: 1891516332
Provider Name (Legal Business Name): JASPREET GAHUNIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 SIMAS DR
MILPITAS CA
95035-4723
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

V. Phone/Fax

Practice location:
  • Phone: 916-214-3248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032609
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95204043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: