Provider Demographics
NPI:1760029847
Name:PANNU, MANPREET KAUR (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MANPREET
Middle Name:KAUR
Last Name:PANNU
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HYDE ST STE 413
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4806
Mailing Address - Country:US
Mailing Address - Phone:415-353-6230
Mailing Address - Fax:415-353-6238
Practice Address - Street 1:900 HYDE ST STE 413
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4806
Practice Address - Country:US
Practice Address - Phone:415-353-6230
Practice Address - Fax:415-353-6238
Is Sole Proprietor?:No
Enumeration Date:2019-12-07
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013457363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health