Basic Information
| Provider Information | |||||||||
| NPI: | 1396187514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUR | ||||||||
| FirstName: | RUPINDER | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4411 E. KINGS CANYON ROAD | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594531008 | ||||||||
| FaxNumber: | 5594532805 | ||||||||
| Practice Location | |||||||||
| Address1: | 4411 E KINGS CANYON RD | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937023604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594531008 | ||||||||
| FaxNumber: | 5594532805 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2013 | ||||||||
| LastUpdateDate: | 07/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 648616 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.