Provider Demographics
NPI:1750119434
Name:AUSTIN, DAMON LOUIS (CRNA)
Entity type:Individual
Prefix:
First Name:DAMON
Middle Name:LOUIS
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 OLD FARM RD APT 244
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6923
Mailing Address - Country:US
Mailing Address - Phone:970-308-0462
Mailing Address - Fax:
Practice Address - Street 1:9300 STOCKDALE HWY STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3611
Practice Address - Country:US
Practice Address - Phone:970-308-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002701367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered