Healthcare Provider Details

I. General information

NPI: 1124968037
Provider Name (Legal Business Name): DR. PANNU PSYCHOLOGICAL SERVICES, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 CROCKER DR
SACRAMENTO CA
95818-3966
US

IV. Provider business mailing address

3328 CROCKER DR
SACRAMENTO CA
95818-3966
US

V. Phone/Fax

Practice location:
  • Phone: 213-444-9465
  • Fax:
Mailing address:
  • Phone: 213-444-9465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: VICTOR SINGH PANNU
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 213-444-9465