Healthcare Provider Details

I. General information

NPI: 1538388855
Provider Name (Legal Business Name): JASJEET KAUR SINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 TENNIS LN
TRACY CA
95376-4417
US

IV. Provider business mailing address

919 S FULTON ST
MOUNTAIN HOUSE CA
95391-1402
US

V. Phone/Fax

Practice location:
  • Phone: 209-740-4483
  • Fax:
Mailing address:
  • Phone: 516-528-2192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number138850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: