Healthcare Provider Details

I. General information

NPI: 1487362539
Provider Name (Legal Business Name): EMMANUEL NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 STOCKDALE HWY. CALIFORNIA STATE UNIVERSITY-DEPARTMENT OF NURSING
BAKERSFIELD CA
93311
US

IV. Provider business mailing address

9001 STOCKDALE HWY. CALIFORNIA STATE UNIVERSITY-DEPARTMENT OF NURSING
BAKERSFIELD CA
93311
US

V. Phone/Fax

Practice location:
  • Phone: 661-654-2505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95030369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: