Individual provider Active NPI

Sanjeevan Atwal-Khanna, NP

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1437424447
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19736 Issued in CA
Practice address
1707 Eye St # 100
Bakersfield, CA 93301
Phone
(661) 310-3688
Fax
(661) 368-0826
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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 19736 CA Primary

Addresses

Primary practice location

1707 Eye St # 100
Bakersfield, CA 93301

Mailing address

1707 Eye St # 100
Bakersfield, CA 93301-5208
Phone (661) 310-3688

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
I20230222001586 CA Practitioner - Nurse Practitioner 1456724483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

2400 Wible Rd
Suite 14
Bakersfield, CA 93304-4734
Phone (661) 835-1240

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

2760 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19736CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Oct 15, 2022 Accepting new patients
Clinica Sierra Vista CurrentSince Oct 15, 2022 Accepting new patients
Psychiatric Medical Practitioners, Inc. Past Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

625 34th St
Ste 100
Bakersfield, CA 93301

2400 Wible Rd
Ste 14
Bakersfield, CA 93304
Phone (661) 725-4780

7800 Niles St
Bakersfield, CA 93306
Phone (661) 328-4284

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1437424447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 EYE ST # 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015208",
            "telephone_number": "661-310-3688",
            "fax_number": "661-368-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 EYE ST # 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93301",
            "telephone_number": "661-310-3688",
            "fax_number": "661-368-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWAL-KHANNA",
        "first_name": "SANJEEVAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.