Provider Demographics
NPI:1710763321
Name:BHANDAL, SARVEJEET KAUR I (ADMINISTRATOR)
Entity Type:Individual
Prefix:MRS
First Name:SARVEJEET
Middle Name:KAUR
Last Name:BHANDAL
Suffix:I
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 PALMERSON DR
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-4617
Mailing Address - Country:US
Mailing Address - Phone:916-494-1481
Mailing Address - Fax:279-529-4104
Practice Address - Street 1:9320 PALMERSON DR
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-4617
Practice Address - Country:US
Practice Address - Phone:916-494-1481
Practice Address - Fax:279-529-4104
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345920019310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility