Provider Demographics
NPI:1780333708
Name:SANDHU, PARAMJIT SINGH (ADMINISTRATOR)
Entity type:Individual
Prefix:
First Name:PARAMJIT
Middle Name:SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 HOMEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4951
Mailing Address - Country:US
Mailing Address - Phone:530-329-3834
Mailing Address - Fax:530-230-0172
Practice Address - Street 1:1301 HOMEWOOD DR
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4951
Practice Address - Country:US
Practice Address - Phone:530-329-3834
Practice Address - Fax:530-230-0172
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577005638310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility