Healthcare Provider Details

I. General information

NPI: 1720704380
Provider Name (Legal Business Name): PUNEET SINGH SAHI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 CUMMINS DR
MODESTO CA
95358
US

IV. Provider business mailing address

1611 MANDEVILLA LN
CERES CA
95307-9673
US

V. Phone/Fax

Practice location:
  • Phone: 209-576-1750
  • Fax:
Mailing address:
  • Phone: 209-765-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number106S00000X
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number101YP2500X
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: