Active NPI
Rubani Sidhu
- Psychiatry Physician
- Fresno, CA
National Provider Identifier
1518685114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A205103
- Practice address
- 4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604 - Phone
- (559) 600-2382
- NPI assigned
- Aug 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1518685114 | CA | |
| Psychiatry Physician | 2084P0800X | 1518685114 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | A205103 | CA | Primary |
Addresses
Primary practice location
4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604
Mailing address
Psychiatric Health Facility (Youth)
#319 4411 E Kings Canyon Rd.
Fresno, CA 93702
Phone (559) 600-2382
Other practice location 1
400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A205103 | CA | MD | Psychiatry Physician |
| 1518685114 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1518685114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PSYCHIATRIC HEALTH FACILITY (YOUTH)",
"address_2": "#319 4411 E KINGS CANYON RD.",
"city": "FRESNO",
"state": "CA",
"postal_code": "93702",
"telephone_number": "559-600-2382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4411 E KINGS CANYON RD # 319",
"city": "FRESNO",
"state": "CA",
"postal_code": "937023604",
"telephone_number": "559-600-2382"
}
],
"practiceLocations": [
{
"address_1": "400 W Mineral King Ave",
"address_purpose": "LOCATION",
"city": "Visalia",
"state": "CA",
"postal_code": "932916237",
"country_code": "US",
"telephone_number": "559-624-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIDHU",
"first_name": "RUBANI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "1518685114",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "1518685114",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A205103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.