Healthcare Provider Details

I. General information

NPI: 1497941611
Provider Name (Legal Business Name): ANGELA A VILLATORO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PHYSICIANS BLVD
BAKERSFIELD CA
93301-1277
US

IV. Provider business mailing address

PO BOX 1559
BAKERSFIELD CA
93302-1559
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-1455
  • Fax: 661-324-3720
Mailing address:
  • Phone: 661-635-3050
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018614
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN835243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: