Provider Demographics
NPI:1508527458
Name:BEHNIWAL, RAMANDEEP KAUR
Entity Type:Individual
Prefix:
First Name:RAMANDEEP
Middle Name:KAUR
Last Name:BEHNIWAL
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 1:893 PATRIOT DR STE A
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3357
Mailing Address - Country:US
Mailing Address - Phone:805-214-1312
Mailing Address - Fax:
Practice Address - Street 1:893 PATRIOT DR STE A
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3357
Practice Address - Country:US
Practice Address - Phone:805-214-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019599363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health