Provider Demographics
NPI:1245957919
Name:ARICHETA, JUDY LYN ARELLANO (MSN, APRN, FNPC)
Entity type:Individual
Prefix:
First Name:JUDY LYN
Middle Name:ARELLANO
Last Name:ARICHETA
Suffix:
Gender:F
Credentials:MSN, APRN, FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 STOCKDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1022
Mailing Address - Country:US
Mailing Address - Phone:661-654-2505
Mailing Address - Fax:
Practice Address - Street 1:9001 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1022
Practice Address - Country:US
Practice Address - Phone:661-654-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA95030367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program