Healthcare Provider Details

I. General information

NPI: 1942031703
Provider Name (Legal Business Name): ANNA MARTINA DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MARTINA SLOOR

II. Dates (important events)

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

III. Provider practice location address

3805 SAN DIMAS ST STE B
BAKERSFIELD CA
93301-5725
US

IV. Provider business mailing address

8200 STOCKDALE HWY # M10-150
BAKERSFIELD CA
93311-1091
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-9999
  • Fax:
Mailing address:
  • Phone: 310-435-9891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number95031303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: