Provider Demographics
NPI:1477117208
Name:JHAWAR, AMANDEEP (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:
Last Name:JHAWAR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W BROADWAY STE 310
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4438
Mailing Address - Country:US
Mailing Address - Phone:562-491-6465
Mailing Address - Fax:562-590-6463
Practice Address - Street 1:333 W BROADWAY STE 310
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4438
Practice Address - Country:US
Practice Address - Phone:562-491-6465
Practice Address - Fax:562-590-6463
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30799103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical