Individual provider Active NPI

Alan Dale Witherell

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bakersfield, CA
National Provider Identifier
1093940652
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
58428 Issued in CA
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

Updated by the provider on Apr 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1835P0018XOtherCAFAMILY 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

LicenseStateTypeSpecialty
58428CAMDPharmacist 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.

Verify at the official NPI Registry.