Healthcare Provider Details

I. General information

NPI: 1831052901
Provider Name (Legal Business Name): KATIE LAYNE BACA DIAZ RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5144
BAKERSFIELD CA
93388-5144
US

IV. Provider business mailing address

118 MINNER AVE
BAKERSFIELD CA
93308-3414
US

V. Phone/Fax

Practice location:
  • Phone: 661-522-7093
  • Fax:
Mailing address:
  • Phone: 661-522-7093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number48108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: