Parbjeet Kaur

Individual provider Active NPI Primary Care Nurse Practitioner · Mountain House, CA

NPI 1336719186 · NPPES record last updated Jun 24, 2021

Key facts

NPI
1336719186
Entity type
Individual (NPI type 1)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
NP95017226 (CA)
Practice address
130 W Invitar LN
Mountain House, CA 95391-2036
Phone
(661) 717-8629
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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 IDStateProvider typePAC IDDetails
I20210930003204 CA Practitioner - Nurse Practitioner 6709283997 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95017226CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatrics Long Term Care Medical Corporation Past
since Jan 21, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP95017226 CA Yes

Addresses

Primary practice location

130 W Invitar LN
Mountain House, CA 95391-2036

Mailing address

130 W Invitar LN
Mountain House, CA 95391-2036
Phone (661) 717-8629

Other identifiers

IdentifierTypeStateIssuer
NP95017226OtherCABOARDS OF REGISTERED NURSING

Other providers in Mountain House, CA

All providers in Mountain House, CA · Primary Care Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.