Healthcare Provider Details

I. General information

NPI: 1336337799
Provider Name (Legal Business Name): NAOMI KAMIL BJORNSTAD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAOMI KAMIL ALVAREZ PA-C

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13646 HIGHWAY 33
LOST HILLS CA
93249-9719
US

IV. Provider business mailing address

5101 SILVER CROSSING ST
BAKERSFIELD CA
93313-4127
US

V. Phone/Fax

Practice location:
  • Phone: 661-797-6691
  • Fax:
Mailing address:
  • Phone: 323-422-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA19334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: