Healthcare Provider Details

I. General information

NPI: 1326599283
Provider Name (Legal Business Name): ANUDEEP BAWA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2016
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8325 BRIMHALL RD STE 100A
BAKERSFIELD CA
93312-2245
US

IV. Provider business mailing address

4120 N 108TH AVE # 116
PHOENIX AZ
85037-5773
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-0003
  • Fax: 661-589-0103
Mailing address:
  • Phone: 623-872-1818
  • Fax: 623-872-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberRN206683
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: