Healthcare Provider Details

I. General information

NPI: 1083308241
Provider Name (Legal Business Name): DIGNITY HEALTH PROVIDER RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 CALIFORNIA AVE
BAKERSFIELD CA
93309-7012
US

IV. Provider business mailing address

4550 CALIFORNIA AVE
BAKERSFIELD CA
93309-7012
US

V. Phone/Fax

Practice location:
  • Phone: 661-716-7100
  • Fax:
Mailing address:
  • Phone: 661-716-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA NICHOLS
Title or Position: REGULATORY COMPLIANCE MANAGER
Credential: RN
Phone: 818-414-8054