Provider Demographics
NPI:1467682260
Name:KAUR, JAGDEEP (MD)
Entity type:Individual
Prefix:
First Name:JAGDEEP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 TIMBERLAKE WAY STE 210B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5414
Mailing Address - Country:US
Mailing Address - Phone:916-917-7316
Mailing Address - Fax:866-481-8756
Practice Address - Street 1:8120 TIMBERLAKE WAY STE 210B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5414
Practice Address - Country:US
Practice Address - Phone:916-917-7316
Practice Address - Fax:866-481-8756
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1702632084A0401X, 2084P0802X, 2084A0401X
PAMD4511092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty