Healthcare Provider Details

I. General information

NPI: 1457381816
Provider Name (Legal Business Name): KATHE DUANNE LUNDGREN ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHE DUANNE LUNDGREN FNP-C

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 UNION AVE
BAKERSFIELD CA
93305-2400
US

IV. Provider business mailing address

3805 UNION AVE
BAKERSFIELD CA
93305-2400
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-7792
  • Fax: 661-323-7778
Mailing address:
  • Phone: 661-323-7792
  • Fax: 661-323-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222749
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number222749
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY5901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: