MEDICARE: JANBIR KAUR SANDHU MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	RC60019291	WA
2	104100000X	Social Worker	26885	CA
3	104100000X	Social Worker	72753	CA

General Provider Information

NPI Number	:	1063671840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANBIR KAUR SANDHU MSW

Provider Business Mailing Address
First Line	:	2010 EL CAMINO REAL
Second Line	:	#623
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-4051
Country	:	US
Telephone Number	:	408-510-7512
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 LITTLE ORCHARD ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-1031
Country	:	US
Telephone Number	:	408-510-7512
Fax Number	:	408-254-9960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	08/12/2016

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