Healthcare Provider Details

I. General information

NPI: 1841710936
Provider Name (Legal Business Name): NAVJEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W ALAMEDA DR
MOUNTAIN HOUSE CA
95391-1144
US

IV. Provider business mailing address

319 W ALAMEDA DR
MOUNTAIN HOUSE CA
95391-1144
US

V. Phone/Fax

Practice location:
  • Phone: 408-816-5121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number812274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: