Healthcare Provider Details

I. General information

NPI: 1962220863
Provider Name (Legal Business Name): RAMINDERJIT KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 FLORIDA AVE STE 100
MODESTO CA
95350-4438
US

IV. Provider business mailing address

6395 OWL WAY
LIVERMORE CA
94551-8789
US

V. Phone/Fax

Practice location:
  • Phone: 209-577-3388
  • Fax: 209-338-0024
Mailing address:
  • Phone: 661-332-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: