Individual provider Active NPI

Sophia Marie Renteria, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1295423127
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023926 Issued in CA
Practice address
2121 17TH St Ste a
Bakersfield, CA 93301-3704
Phone
(661) 323-3280
NPI assigned
Apr 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023926 CA Primary

Addresses

Primary practice location

2121 17TH St Ste a
Bakersfield, CA 93301-3704

Mailing address

4004 Peachwood CT
Bakersfield, CA 93309-6479
Phone (661) 336-8919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301003011 CA Practitioner - Nurse Practitioner 5092150821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kern County Hospital AuthorityGroup PAC ID 4688964521, 264 clinicians

Practice addresses (Care Compare)

1111 Columbus St
Bakersfield, CA 93305-1936
Phone (661) 326-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023926CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hector de Jesus M.D., Inc CurrentSince Apr 30, 2023 Accepting new patients
Kern County Hospital Authority CurrentSince Feb 1, 2024 Accepting new patients
Kern County Hospital Authority CurrentSince Feb 1, 2024 Accepting new patients

Locations

2121 17th St
Ste A
Bakersfield, CA 93301
Phone (661) 323-3280

1111 Columbus St
Bakersfield, CA 93305
Phone (661) 326-5052

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1295423127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 PEACHWOOD CT",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933096479",
            "telephone_number": "661-336-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 17TH ST STE A",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013704",
            "telephone_number": "661-323-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA",
        "first_name": "SOPHIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.