Individual provider Active NPI

Sukhdeep Kaur Dhaliwal, FNP-C

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1083089437
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95002651 Issued in CA
Practice address
2740 S Elm Ave
Fresno, CA 93706-5435
Phone
(559) 457-5200
Fax
(559) 457-5296
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95002651 CA Primary

Addresses

Primary practice location

2740 S Elm Ave
Fresno, CA 93706-5435

Mailing address

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330001357 CA Practitioner - Nurse Practitioner 4082911474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

1350 S Orange Ave
Fresno, CA 93702-3463
Phone (559) 457-5400

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

2760 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024019CAMDRegistered Nurse
NP95002651CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Mar 14, 2016 Accepting new patients
Clinica Sierra Vista CurrentSince Mar 14, 2016 Accepting new patients
Clinica Sierra Vista Current Accepting new patients

Locations

2740 S Elm Ave
Fresno, CA 93706
Phone (559) 457-5200

3727 N 1st St
Ste 106
Fresno, CA 93726
Phone (559) 457-6900

1350 S Orange Ave
Fresno, CA 93702
Phone (559) 457-5400

Interoperability endpoints

  • Direct secure messaging: sdhaliwal19083@clinicasierravista.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1083089437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 S ELM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065435",
            "telephone_number": "559-457-5200",
            "fax_number": "559-457-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S ELM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065435",
            "telephone_number": "559-457-5200",
            "fax_number": "559-457-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "SUKHDEEP",
        "middle_name": "KAUR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95002651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.