Mankamal Dosanjh, FNP
Individual provider Active NPI Family Nurse Practitioner · Selma, CA
NPI 1104700996 · NPPES record last updated Aug 4, 2025
Key facts
- NPI
- 1104700996
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95036460 (CA)
- Practice address
- 2705 Highland Ave
Selma, CA 93662-3389 - Phone
- (800) 492-4227
- NPI assigned
- Aug 4, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251203003042 | CA | Order and Referring Only - Nurse Practitioner | 1254824691 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95036460 | CA | MD | Family Nurse Practitioner |
Interoperability endpoints
- mankamal.dosanjh.1@17661.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95036460 | CA | Yes |
Addresses
Primary practice location
2705 Highland Ave
Selma, CA 93662-3389
Mailing address
2705 Highland Ave
Selma, CA 93662-3389
Other providers in Selma, CA
- Deepli Malla DDS
- Alexandra Llamas Diaz
- Daniela Diaz
- Socorro Marquez Diaz
- Allison Dobrinin
- Timothy C Doughty
- Shady Dous Sr.
- Irina Drapey
- Jennifer Blythe Duyst
- Dva Healthcare Renal Care Inc
All providers in Selma, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.