Provider Demographics
NPI:1821707738
Name:SANGHERA, GIAN
Entity Type:Individual
Prefix:
First Name:GIAN
Middle Name:
Last Name:SANGHERA
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 1:303 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2266
Mailing Address - Country:US
Mailing Address - Phone:925-383-7392
Mailing Address - Fax:
Practice Address - Street 1:303 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2266
Practice Address - Country:US
Practice Address - Phone:925-383-7392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer