Healthcare Provider Details

I. General information

NPI: 1154966513
Provider Name (Legal Business Name): SHALEEN KAUR DUHRA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

IV. Provider business mailing address

9123 OAKHOLLOW CT
GRANITE BAY CA
95746-8905
US

V. Phone/Fax

Practice location:
  • Phone: 916-956-7701
  • Fax:
Mailing address:
  • Phone: 916-956-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPRS2024-0006
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: