Healthcare Provider Details

I. General information

NPI: 1568396190
Provider Name (Legal Business Name): SUKHVIR KAUR GARCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 C ST
PATTERSON CA
95363-2701
US

IV. Provider business mailing address

2107 SHENANDOAH DR
TRACY CA
95377-6631
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-4842
  • Fax:
Mailing address:
  • Phone: 209-639-8005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: