Provider Demographics
NPI:1578092516
Name:DHILLON, AMAN (MS)
Entity Type:Individual
Prefix:
First Name:AMAN
Middle Name:
Last Name:DHILLON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:AMANDEEP
Other - Middle Name:
Other - Last Name:DHILLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:9130 NOLAN ST APT 2020
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7546
Mailing Address - Country:US
Mailing Address - Phone:510-303-1792
Mailing Address - Fax:
Practice Address - Street 1:9130 NOLAN ST APT 2020
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7546
Practice Address - Country:US
Practice Address - Phone:510-303-1792
Practice Address - Fax:510-303-1792
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-04
Last Update Date:2017-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP25093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty