Basic Information
| Provider Information | |||||||||
| NPI: | 1891284824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUR | ||||||||
| FirstName: | BALJIT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 735 LASK DR | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959917320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303291187 | ||||||||
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| Practice Location | |||||||||
| Address1: | 313 LENNON LN STE 100 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945982460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252891090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2018 | ||||||||
| LastUpdateDate: | 05/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.