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General NPI Number Information
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NPI Number | 1790495000
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Entity Type | Individual
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Provider Name | CRISTOPHER BACIERTO NP
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Gender | Male
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 3509 COFFEE RD STE D3
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City | MODESTO
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State | CA
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Zip | 95355-1357
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Country | US
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Telephone | 844-227-7599
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Fax | 855-903-5155
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Provider Business Mailing Address
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Address Line | 3820 DRAGOO PARK DR
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City | MODESTO
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State | CA
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Zip | 95356-1845
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Country | US
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Telephone | 209-602-4212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95023007
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License Number State | CA
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