Healthcare Provider Details

I. General information

NPI: 1609517614
Provider Name (Legal Business Name): MANPREET K SINGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87225 CHURCH ST
THERMAL CA
92274-8901
US

IV. Provider business mailing address

2818 E BERRY LOOP PRIVADO UNIT 76
ONTARIO CA
91761-3011
US

V. Phone/Fax

Practice location:
  • Phone: 760-399-5137
  • Fax:
Mailing address:
  • Phone: 909-827-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number28557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: