=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093811085
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDY ANN KAIA N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2006
-----------------------------------------------------
Last Update Date | 10/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 DISCOVERY DR
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-7032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-852-3693
-----------------------------------------------------
Fax | 661-852-3600
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13300 SMOKE CREEK AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93314-9025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-587-7236
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 320359
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------