Provider Demographics
NPI:1215816269
Name:HUNDAL, JAGJIT K
Entity type:Individual
Prefix:
First Name:JAGJIT
Middle Name:K
Last Name:HUNDAL
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 1:35 JAN CT STE 150
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4418
Mailing Address - Country:US
Mailing Address - Phone:530-899-8853
Mailing Address - Fax:530-899-8854
Practice Address - Street 1:35 JAN CT STE 150
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4418
Practice Address - Country:US
Practice Address - Phone:530-899-8853
Practice Address - Fax:530-899-8854
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036633363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner