Individual
NANCY BANUELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4900 CALIFORNIA AVE, 400B, BAKERSFIELD, CA 93309-7024
(661) 459-1900
(661) 459-1974
Mailing address
4900 CALIFORNIA AVE, 400B, BAKERSFIELD, CA 93309-7081
(661) 459-1900
(661) 459-1974
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
612020
CA
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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