Provider Demographics
NPI:1679877450
Name:SIDHU, AMANDEEP KAUR
Entity type:Individual
Prefix:
First Name:AMANDEEP
Middle Name:KAUR
Last Name:SIDHU
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 1:9261 FOLSOM BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2561
Mailing Address - Country:US
Mailing Address - Phone:916-369-7872
Mailing Address - Fax:
Practice Address - Street 1:3780 ROSIN CT
Practice Address - Street 2:SUITE 240
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1646
Practice Address - Country:US
Practice Address - Phone:916-369-7872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator