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NPI Code Detail

MEDICARE: DEBRA BAKERJIAN PHD, MSN, APRN, FNP

MEDICARE: DEBRA BAKERJIAN PHD, MSN, APRN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner4924CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14924OTHERCANP LICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3284559OTHERCARN LICENSE NUMBER

General Provider Information

NPI Number : 1306872544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA BAKERJIAN PHD, MSN, APRN, FNP
Provider Business Mailing Address
First Line : 5150 FAIR OAKS BLVD # 101-333
Second Line :
City : CARMICHAEL
State : CA
Zip : 95608-5758
Country : US
Telephone Number : 415-302-9500
Fax Number :
Provider Business Practice Location Address
First Line : 2570 48TH ST STE 2145
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1541
Country : US
Telephone Number : 916-734-7124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 03/07/2023

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