Provider Demographics
NPI:1336718949
Name:GREWAL, JANNAT KAUR
Entity Type:Individual
Prefix:
First Name:JANNAT
Middle Name:KAUR
Last Name:GREWAL
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 1:9904 GOLD DUST DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3025
Mailing Address - Country:US
Mailing Address - Phone:661-345-3779
Mailing Address - Fax:
Practice Address - Street 1:9904 GOLD DUST DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3025
Practice Address - Country:US
Practice Address - Phone:661-345-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician