Healthcare Provider Details

I. General information

NPI: 1093811085
Provider Name (Legal Business Name): JUDY ANN KAIA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DISCOVERY DR
BAKERSFIELD CA
93309-7032
US

IV. Provider business mailing address

13300 SMOKE CREEK AVE
BAKERSFIELD CA
93314-9025
US

V. Phone/Fax

Practice location:
  • Phone: 661-852-3693
  • Fax: 661-852-3600
Mailing address:
  • Phone: 661-587-7236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number320359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: