Healthcare Provider Details

I. General information

NPI: 1144596016
Provider Name (Legal Business Name): ELENA ALEKSEEVNA VELAZQUEZ CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 11/06/2022
Certification Date: 11/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 CHESTER AVE
BAKERSFIELD CA
93301-2014
US

IV. Provider business mailing address

6412 MOUNT BACHELOR LN
BAKERSFIELD CA
93312-6183
US

V. Phone/Fax

Practice location:
  • Phone: 661-395-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP126358
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9241846
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: