Provider Demographics
NPI:1225803935
Name:JKBRAR, A PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:JKBRAR, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:ARKHAM WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESKEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-229-2611
Mailing Address - Street 1:15615 ALTON PKWY STE 450
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3308
Mailing Address - Country:US
Mailing Address - Phone:949-229-2611
Mailing Address - Fax:
Practice Address - Street 1:19712 MACARTHUR BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612
Practice Address - Country:US
Practice Address - Phone:949-229-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty