Provider Demographics
NPI:1083857239
Name:KHALSA, SAT KAUR
Entity Type:Individual
Prefix:DR
First Name:SAT KAUR
Middle Name:
Last Name:KHALSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E CORONADO RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-0610
Mailing Address - Country:US
Mailing Address - Phone:505-986-1876
Mailing Address - Fax:505-820-0197
Practice Address - Street 1:1452 26TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3084
Practice Address - Country:US
Practice Address - Phone:310-828-2210
Practice Address - Fax:505-820-0197
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18406106H00000X
NMLPCC0350106H00000X
NMLMFT0349106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist