Individual provider Active NPI

Mandeep Kaur, RN

  • Ambulatory Care Registered Nurse
  • Sacramento, CA
National Provider Identifier
1669183489
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
95223345 Issued in CA
Practice address
3257 Folsom Blvd
Sacramento, CA 95816-5220
Phone
(916) 442-5891
NPI assigned
Dec 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95223345 CA
Gerontology Registered Nurse 163WG0600X 95223345 CA
Ambulatory Care Registered Nurse 163WP2201X 95223345 CA Primary

Addresses

Primary practice location

3257 Folsom Blvd
Sacramento, CA 95816-5220

Mailing address

11712 Brook Valley Way
Rancho Cordova, CA 95742-8025
Phone (916) 926-3309

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95223345CAMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1669183489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 BROOK VALLEY WAY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957428025",
            "telephone_number": "916-926-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165220",
            "telephone_number": "916-442-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "MANDEEP",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95223345",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CA",
            "license": "95223345",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "95223345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.