Provider Demographics
NPI:1790202646
Name:SANDHU, NARITA KAUR
Entity Type:Individual
Prefix:
First Name:NARITA
Middle Name:KAUR
Last Name:SANDHU
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 1:297 E CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-8288
Mailing Address - Country:US
Mailing Address - Phone:734-772-2904
Mailing Address - Fax:
Practice Address - Street 1:9355 E STOCKTON BLVD STE 214
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9528
Practice Address - Country:US
Practice Address - Phone:916-318-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140886101YM0800X
CA101YS0200X
101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool