Healthcare Provider Details

I. General information

NPI: 1992388060
Provider Name (Legal Business Name): PAMELA DENISE COLEMAN-SNOW PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA DENISE COLEMAN PMHNP

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 EYE ST., STE. 100
BAKERSFIELD CA
93301
US

IV. Provider business mailing address

28039 SCOTT RD STE D-231
MURRIETA CA
92563-7479
US

V. Phone/Fax

Practice location:
  • Phone: 661-310-3688
  • Fax:
Mailing address:
  • Phone: 951-205-0715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95017697
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number548317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: