Provider Demographics
NPI:1679165013
Name:CHHABRA, SIMRAN (FNP)
Entity type:Individual
Prefix:
First Name:SIMRAN
Middle Name:
Last Name:CHHABRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 W GRAND AVE APT 725
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2336
Mailing Address - Country:US
Mailing Address - Phone:224-770-1981
Mailing Address - Fax:
Practice Address - Street 1:438 W GRAND AVE APT 725
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2336
Practice Address - Country:US
Practice Address - Phone:224-770-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016538363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty