Provider Demographics
NPI:1659902658
Name:SANDHU, JARNAIL SINGH
Entity type:Individual
Prefix:
First Name:JARNAIL
Middle Name:SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902-0191
Mailing Address - Country:US
Mailing Address - Phone:559-898-7574
Mailing Address - Fax:
Practice Address - Street 1:130 W GABILAN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2762
Practice Address - Country:US
Practice Address - Phone:831-758-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2024-10-24
Deactivation Date:2021-02-05
Deactivation Code:
Reactivation Date:2021-03-08
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 390200000X
CA1269071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program