Healthcare Provider Details

I. General information

NPI: 1316410095
Provider Name (Legal Business Name): JASWINDER KAUR SEKHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2019
Last Update Date: 01/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

IV. Provider business mailing address

4920 KNIGHTS WAY
ROCKLIN CA
95765-5041
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-4777
  • Fax:
Mailing address:
  • Phone: 916-719-6407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number24612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: