Healthcare Provider Details

I. General information

NPI: 1013843515
Provider Name (Legal Business Name): MARSHA RENE RADSICK NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13308 BOTTICELLI CT
BAKERSFIELD CA
93306-7736
US

IV. Provider business mailing address

13308 BOTTICELLI CT
BAKERSFIELD CA
93306-7736
US

V. Phone/Fax

Practice location:
  • Phone: 661-343-5733
  • Fax:
Mailing address:
  • Phone: 661-343-5733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95039747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: