Healthcare Provider Details

I. General information

NPI: 1801721964
Provider Name (Legal Business Name): MARIA PAULETTE CARLOTA TANTIADO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA PAULETTE BOLOTAOLO CARLOTA

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 COFFEE RD STE 100
BAKERSFIELD CA
93309-1273
US

IV. Provider business mailing address

13061 ROSEDALE HWY STE G534
BAKERSFIELD CA
93314-7612
US

V. Phone/Fax

Practice location:
  • Phone: 661-885-6060
  • Fax: 661-885-6085
Mailing address:
  • Phone: 661-376-0643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: