Provider Demographics
NPI:1568406957
Name:SANDHU, PRABJOT K (NP)
Entity Type:Individual
Prefix:
First Name:PRABJOT
Middle Name:K
Last Name:SANDHU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:SANDHU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4725 1ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7366
Mailing Address - Country:US
Mailing Address - Phone:925-462-7060
Mailing Address - Fax:
Practice Address - Street 1:4725 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7366
Practice Address - Country:US
Practice Address - Phone:925-462-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14733363L00000X, 363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health