Healthcare Provider Details

I. General information

NPI: 1205547049
Provider Name (Legal Business Name): KIRANJEET KAUR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 S ORANGE AVE
WEST COVINA CA
91790-2662
US

IV. Provider business mailing address

741 S ORANGE AVE
WEST COVINA CA
91790-2662
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-7117
  • Fax:
Mailing address:
  • Phone: 626-960-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95038128
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number802075
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: