Healthcare Provider Details

I. General information

NPI: 1053809624
Provider Name (Legal Business Name): HARMANDEEP KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2018
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date: 04/14/2023
Reactivation Date: 05/02/2023

III. Provider practice location address

2230 W CHAPMAN AVE STE 209
ORANGE CA
92868-2316
US

IV. Provider business mailing address

148 SUNSET DR
MOUNT JULIET TN
37122-2928
US

V. Phone/Fax

Practice location:
  • Phone: 714-340-7755
  • Fax:
Mailing address:
  • Phone: 714-829-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: