Individual provider Active NPI

Faustino Enriquez, FNP-C

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1609525963
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020266 Issued in CA
Practice address
301 Brundage LN
Bakersfield, CA 93304-3248
Phone
(661) 323-6086
Fax
(661) 324-6301
NPI assigned
Mar 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 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 95020266 CA Primary

Addresses

Primary practice location

301 Brundage LN
Bakersfield, CA 93304-3248

Mailing address

301 Brundage LN
Bakersfield, CA 93304-3248
Phone (661) 323-6086

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220510002097 CA Practitioner - Nurse Practitioner 5890172969 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3501 Stockdale Hwy
Bakersfield, CA 93309-2150
Phone (661) 328-9831

3733 San Dimas St
Suite 101
Bakersfield, CA 93301-1407
Phone (800) 353-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95020266CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 8, 2023 Accepting new patients
Emergency Physicians Urgent Care Inc. CurrentSince May 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 8, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Emergency Physicians Urgent Care Inc. CurrentSince May 1, 2022 Accepting new patients
Cep America-California CurrentSince Feb 21, 2023 Accepting new patients
Cep America - California Current Accepting new patients
Cep America - California CurrentSince Feb 21, 2023 Accepting new patients
Kern County Hospital Authority CurrentSince Nov 1, 2022 Accepting new patients
Cep America - California CurrentSince Feb 21, 2023 Accepting new patients
Cep America - California Current Accepting new patients
Universal Healthcare Ipa, Inc. Past Accepting new patients

Locations

9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 331-8640

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

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

212 Coffee Rd
Bakersfield, CA 93309
Phone (661) 829-6937

3733 San Dimas St
Bakersfield, CA 93301
Phone (661) 631-3008

212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060

4108 Edison Ave
Ste 112
Chino, CA 91710
Phone (909) 334-4545

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

6789 N Blackstone Ave
Fresno, CA 93710
Phone (559) 512-3377

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

41540 Winchester Rd
Temecula, CA 92590
Phone (951) 365-5585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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 1

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1609525963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BRUNDAGE LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933043248",
            "telephone_number": "661-323-6086",
            "fax_number": "661-324-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BRUNDAGE LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933043248",
            "telephone_number": "661-323-6086",
            "fax_number": "661-324-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "FAUSTINO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2023-12-22",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.