Provider Demographics
NPI:1508927096
Name:MALHI-JANDU, SIMARBIR KAUR
Entity Type:Individual
Prefix:MRS
First Name:SIMARBIR
Middle Name:KAUR
Last Name:MALHI-JANDU
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SIMARBIR
Other - Middle Name:KAUR
Other - Last Name:MALHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6569 N RIVERSIDE DR STE 102 BOX 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3894 E GETTYSBURG AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0901
Practice Address - Country:US
Practice Address - Phone:559-252-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA48849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health