Healthcare Provider Details

I. General information

NPI: 1194647909
Provider Name (Legal Business Name): JAWARIA QASIM CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 CHESTER AVE
BAKERSFIELD CA
93301-2014
US

IV. Provider business mailing address

1900 INLAND EMPIRE BLVD UNIT 4004
ONTARIO CA
91764-1888
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 TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95225013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: