Healthcare Provider Details

I. General information

NPI: 1598669525
Provider Name (Legal Business Name): NAVDEEP KAUR PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 CLUB DRIVE, MARE ISLAND
VALLEJO CA
94592
US

IV. Provider business mailing address

5500 EUCALYPTUS DR
AMERICAN CANYON CA
94503-1170
US

V. Phone/Fax

Practice location:
  • Phone: 707-638-5200
  • Fax:
Mailing address:
  • Phone: 463-867-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: