Provider Demographics
NPI:1063279776
Name:KHROUD, HARSHPREET KAUR
Entity type:Individual
Prefix:
First Name:HARSHPREET
Middle Name:KAUR
Last Name:KHROUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HARSHPREET
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6645 E FARRIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-0819
Mailing Address - Country:US
Mailing Address - Phone:559-940-0084
Mailing Address - Fax:
Practice Address - Street 1:6645 E FARRIN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-0819
Practice Address - Country:US
Practice Address - Phone:559-940-0084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029107363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health