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NPI 1609768530

NPI 1609768530 : KIRIN SIDHU PMHNP-BC : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1609768530
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    Entity Type          |    Individual 
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    Provider Name        |    KIRIN SIDHU PMHNP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/16/2025
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    Last Update Date     |    11/21/2025
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Provider Practice Location Address
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    Address Line         |    1245 S WINCHESTER BLVD STE 110 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95128-3908
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    Country              |    US
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    Telephone            |    925-282-1778
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1245 S WINCHESTER BLVD STE 110 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95128-3908
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    Country              |    US
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    Telephone            |    925-282-1778
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    95035691
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    95171387
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    License Number State |    CA
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