Healthcare Provider Details
I. General information
NPI: 1881274405
Provider Name (Legal Business Name): MRS. GERALDINE DULLAS LAPLANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/08/2021
Last Update Date: 05/21/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5030 OFFICE PARK DRIVE
BAKERSFIELD CA
93309
US
IV. Provider business mailing address
4507 CHALET ST
BAKERSFIELD CA
93313-2056
US
V. Phone/Fax
- Phone: 661-323-2847
- Fax: 661-323-2261
- Phone: 661-431-3787
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95017183 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: