Provider Demographics
NPI:1710731666
Name:DHERI, PARMINDER KAUR
Entity Type:Individual
Prefix:
First Name:PARMINDER
Middle Name:KAUR
Last Name:DHERI
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 1:2554 GANTRY DR
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-2093
Mailing Address - Country:US
Mailing Address - Phone:530-933-6040
Mailing Address - Fax:
Practice Address - Street 1:2554 GANTRY DR
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-2093
Practice Address - Country:US
Practice Address - Phone:530-933-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2024002932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily