Active NPI
Stacyrae Viason Agusto
- Nurse Practitioner
- Bakersfield, CA
National Provider Identifier
1174329403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95034047
- Practice address
- 8501 Brimhall Rd BLDG 100
Bakersfield, CA 93312-2327 - Phone
- (661) 370-0777
- Fax
- (661) 654-8366
- NPI assigned
- Feb 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95034047 | CA | Primary |
Addresses
Primary practice location
8501 Brimhall Rd BLDG 100
Bakersfield, CA 93312-2327
Mailing address
8501 Brimhall Rd BLDG 100
Bakersfield, CA 93312-2327
Phone (661) 370-0777
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 |
|---|---|---|---|
| 95034047 | CA | MD | Nurse Practitioner |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1174329403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8501 BRIMHALL RD BLDG 100",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933122327",
"telephone_number": "661-370-0777",
"fax_number": "661-654-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8501 BRIMHALL RD BLDG 100",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933122327",
"telephone_number": "661-370-0777",
"fax_number": "661-654-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGUSTO",
"first_name": "STACYRAE",
"middle_name": "VIASON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-19",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95034047",
"primary": true
}
],
"identifiers": [],
"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 Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.