Individual provider Active NPI

Manjinder Kaur

  • Nurse Practitioner
  • Antioch, CA
National Provider Identifier
1649197997
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95040206 Issued in CA
Practice address
3550 Countryside Way
Antioch, CA 94509-6286
Phone
(925) 529-5872
NPI assigned
Jun 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95040206 CA Primary

Addresses

Primary practice location

3550 Countryside Way
Antioch, CA 94509-6286

Mailing address

3550 Countryside Way
Antioch, CA 94509-6286

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

NPI Registry JSON

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1649197997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 COUNTRYSIDE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 COUNTRYSIDE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096286",
            "telephone_number": "925-529-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "MANJINDER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95040206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.