Basic Information
Provider Information
NPI: 1801307517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THIND
FirstName: DILPREET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 13709 S HUGHES AVE
Address2:  
City: CARUTHERS
State: CA
PostalCode: 936099577
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4411 E KINGS CANYON RD
Address2:  
City: FRESNO
State: CA
PostalCode: 937023604
CountryCode: US
TelephoneNumber: 5596002382
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/20/2017
LastUpdateDate: 10/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808X95137288CAY193400000X SINGLE SPECIALTY GROUPNursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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