Active NPI
Alan Dale Witherell
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Bakersfield, CA
National Provider Identifier
1093940652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 58428
- Practice address
- 9001 Stockdale Hwy Ste 28HC
Bakersfield, CA 93311-1022 - Phone
- (661) 654-3304
- Fax
- (661) 654-2573
- NPI assigned
- May 26, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58428 | CA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 58428 | CA | Primary |
Addresses
Primary practice location
9001 Stockdale Hwy Ste 28HC
Bakersfield, CA 93311-1022
Mailing address
10503 Fisichella LN
Bakersfield, CA 93314-8147
Phone (661) 873-5190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1835P0018X | Other | CA | FAMILY PACT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58428 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1093940652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10503 FISICHELLA LN",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933148147",
"telephone_number": "661-873-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9001 STOCKDALE HWY STE 28HC",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933111022",
"telephone_number": "661-654-3304",
"fax_number": "661-654-2573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERELL",
"first_name": "ALAN",
"middle_name": "DALE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-26",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "58428",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "58428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAMILY PACT",
"identifier": "1835P0018X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.