Individual provider Active NPI

Supneet Kaur

  • Family Nurse Practitioner
  • San Ramon, CA
National Provider Identifier
1730514340
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95000087 Issued in CA
Practice address
2455 San Ramon Valley Blvd
CVS Minute Clinic # 9868
San Ramon, CA 94583-1601
Phone
(866) 389-2727
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95000087 CA Primary

Addresses

Primary practice location

2455 San Ramon Valley Blvd
CVS Minute Clinic # 9868
San Ramon, CA 94583-1601

Mailing address

453 Nassau LN
Hayward, CA 94544-7321
Phone (209) 241-7458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001090 CA Practitioner - Nurse Practitioner 9931406980 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95000087CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sharwin Tafazoli Inc CurrentSince Dec 20, 2025 Accepting new patients

Locations

3828 Delmas Ter
Culver City, CA 90232
Phone (310) 202-4745

4343 N Sierra Way
Sn Bernrdno, CA 92407
Phone (909) 886-4731

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1730514340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 NASSAU LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447321",
            "telephone_number": "209-241-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 SAN RAMON VALLEY BLVD",
            "address_2": "CVS MINUTE CLINIC # 9868",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831601",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SUPNEET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95000087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.