Provider Demographics
NPI:1851794457
Name:KHOSA, JASPREET KAUR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JASPREET
Middle Name:KAUR
Last Name:KHOSA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JASPREET
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2020 E COPPER AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-5402
Mailing Address - Country:US
Mailing Address - Phone:559-433-1290
Mailing Address - Fax:559-433-1296
Practice Address - Street 1:2020 E COPPER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93730-5402
Practice Address - Country:US
Practice Address - Phone:559-433-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-27
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH 71466OtherCALIFORNIA BOARD OF PHARMACY