Provider Demographics
NPI:1164398350
Name:SOHI, JASVIR SINGH
Entity type:Individual
Prefix:
First Name:JASVIR
Middle Name:SINGH
Last Name:SOHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 ERICKSON CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-6354
Mailing Address - Country:US
Mailing Address - Phone:209-808-3716
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1975 ERICKSON CIR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-6354
Practice Address - Country:US
Practice Address - Phone:209-808-3716
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6074363740320900000X
CA392701619376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities