Provider Demographics
NPI:1811670003
Name:SIDHU, PARVINDER KAUR
Entity type:Individual
Prefix:
First Name:PARVINDER
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PARVINDER
Other - Middle Name:KAUR
Other - Last Name:JANGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1160 MINARETS AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-0316
Mailing Address - Country:US
Mailing Address - Phone:559-444-3443
Mailing Address - Fax:
Practice Address - Street 1:496 S BARTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2985
Practice Address - Country:US
Practice Address - Phone:559-860-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN734526164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse