Provider Demographics
NPI:1982413605
Name:HANS, PREETKAMAL
Entity type:Individual
Prefix:
First Name:PREETKAMAL
Middle Name:
Last Name:HANS
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 1:45 BANYAN ST
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1517
Mailing Address - Country:US
Mailing Address - Phone:707-853-9458
Mailing Address - Fax:
Practice Address - Street 1:45 BANYAN ST
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1517
Practice Address - Country:US
Practice Address - Phone:707-853-9458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF12240762363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner