Provider Demographics
NPI:1255199089
Name:KOUR, SUMANJEET
Entity type:Individual
Prefix:
First Name:SUMANJEET
Middle Name:
Last Name:KOUR
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 1:631 RIVER OAKS PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1907
Mailing Address - Country:US
Mailing Address - Phone:408-914-7478
Mailing Address - Fax:
Practice Address - Street 1:2880 ZANKER RD STE 203
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-2122
Practice Address - Country:US
Practice Address - Phone:408-752-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician