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Individual

MRS. AMANDEEP KAUR JOHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1140 MAIN ST, LIVINGSTON, CA 95334
(209) 394-7913
Mailing address
1140 MAIN ST, LIVINGSTON, CA 95334-1257
(209) 394-7913
(209) 394-9093

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95063589
CA
363LF0000X
Family Nurse Practitioner
Primary
95009408
CA

Other

Enumeration date
06/18/2018
Last updated
08/10/2018
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