Provider Demographics
NPI:1376968263
Name:GILL, NAVREET KAUR
Entity Type:Individual
Prefix:
First Name:NAVREET
Middle Name:KAUR
Last Name:GILL
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 1:1811 N MARION AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-9176
Mailing Address - Country:US
Mailing Address - Phone:559-905-1997
Mailing Address - Fax:
Practice Address - Street 1:3451 W SHAW AVE # 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3242
Practice Address - Country:US
Practice Address - Phone:559-260-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34932167G00000X, 247200000X
CA11524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other