Active NPI
Supneet Kaur
- Family Nurse Practitioner
- San Ramon, CA
National Provider Identifier
1730514340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP95000087
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95000087 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharwin Tafazoli Inc | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.