Healthcare Provider Details

I. General information

NPI: 1265514467
Provider Name (Legal Business Name): TRIPJEET BIRRING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 MAIN ST
NEWMAN CA
95360-1326
US

IV. Provider business mailing address

1349 MAIN ST
NEWMAN CA
95360-1326
US

V. Phone/Fax

Practice location:
  • Phone: 209-862-3604
  • Fax:
Mailing address:
  • Phone: 209-862-3604
  • Fax: 209-862-3904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP10690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: