Healthcare Provider Details

I. General information

NPI: 1093020935
Provider Name (Legal Business Name): CAROL ABENA SAKYIBEA ADDO-YOBO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL SACKEY NP

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 ROBERTS LN
BAKERSFIELD CA
93308-4799
US

IV. Provider business mailing address

525 ROBERTS LN
BAKERSFIELD CA
93308-4799
US

V. Phone/Fax

Practice location:
  • Phone: 661-392-7850
  • Fax: 661-215-2349
Mailing address:
  • Phone: 661-392-7850
  • Fax: 661-215-2349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20004
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number670057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: