Provider Demographics
NPI:1821131129
Name:RANDHAWA, RAJDEEP KAUR (MFT)
Entity Type:Individual
Prefix:MRS
First Name:RAJDEEP
Middle Name:KAUR
Last Name:RANDHAWA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 RICHLAND RD STE 2
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-6267
Mailing Address - Country:US
Mailing Address - Phone:530-315-7543
Mailing Address - Fax:
Practice Address - Street 1:849 RICHLAND RD STE 2
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6267
Practice Address - Country:US
Practice Address - Phone:530-315-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50524106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANAOtherNA