Jasleen Kaur Agroia, NP
Individual provider Active NPI Family Nurse Practitioner · Folsom, CA
NPI 1457069296 · NPPES record last updated Dec 6, 2023
Key facts
- NPI
- 1457069296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95022384 (CA)
- Practice address
- 2575 E Bidwell St
Folsom, CA 95630-6444 - Phone
- (916) 531-7100
- NPI assigned
- Nov 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20230829001115 | CA | Practitioner - Nurse Practitioner | 3173986874 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95022384 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Folsom Lake Primary Care PC | Current |
Accepting new patients |
Locations
2575 E Bidwell St
Ste 210
Folsom, CA 95630
Phone (916) 790-0450
Interoperability endpoints
- jkauragroia641713@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95022384 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95022384 | CA | Yes |
Addresses
Primary practice location
2575 E Bidwell St
Folsom, CA 95630-6444
Mailing address
2575 E Bidwell St
Folsom, CA 95630-6444
Phone (916) 531-7100
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All providers in Folsom, 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 Dec 6, 2023. 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.