Provider Demographics
NPI:1548833767
Name:BOYE, JYOTPREET KAUR
Entity type:Individual
Prefix:
First Name:JYOTPREET
Middle Name:KAUR
Last Name:BOYE
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 1:426 CALLE CONVERSE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1838
Mailing Address - Country:US
Mailing Address - Phone:805-824-9197
Mailing Address - Fax:
Practice Address - Street 1:18107 SHERMAN WAY STE 100
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4564
Practice Address - Country:US
Practice Address - Phone:877-783-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-24
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily