=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477805554
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TREVOR D. WILLIAMS PA-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2012
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6001 TRUXTUN AVE STE D400
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-0679
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-323-8477
-----------------------------------------------------
Fax | 661-323-8472
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1139
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93302-1139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-371-2796
-----------------------------------------------------
Fax | 661-438-1746
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA19786
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------