Healthcare Provider Details

I. General information

NPI: 1386928851
Provider Name (Legal Business Name): SARAH LEANN HUTAIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E VALENCIA MESA DR
FULLERTON CA
92835-3809
US

IV. Provider business mailing address

8501 BRIMHALL RD STE 300
BAKERSFIELD CA
93312-2254
US

V. Phone/Fax

Practice location:
  • Phone: 714-626-8500
  • Fax:
Mailing address:
  • Phone: 661-410-2942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number21841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: