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General NPI Number Information
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NPI Number | 1598251399
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Entity Type | Individual
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Provider Name | PARDEEP KUMAR NANGLU JR. QMHS, LPPC TRAINEE
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Gender | Male
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 9121 FOLSOM BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95826-2473
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Country | US
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Telephone | 916-516-1865
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Fax |
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Provider Business Mailing Address
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Address Line | 7610 HEATHERPACE DR
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City | SACRAMENTO
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State | CA
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Zip | 95829-6143
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Country | US
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Telephone | 279-245-3149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 25-QMHS-L-0018
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License Number State | CA
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