Provider Demographics
NPI:1902398563
Name:BAINS, JASMEEN KAUR
Entity Type:Individual
Prefix:
First Name:JASMEEN
Middle Name:KAUR
Last Name:BAINS
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 1:5060 MONTEVERDE LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-7912
Mailing Address - Country:US
Mailing Address - Phone:916-990-8609
Mailing Address - Fax:
Practice Address - Street 1:6030 W OAKS BLVD STE 170
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4437
Practice Address - Country:US
Practice Address - Phone:916-824-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician