Individual provider · NPI-1

Stacyrae Viason Agusto

Nurse Practitioner · Bakersfield, CA

NPI number1174329403
StatusActive
Last updated in NPPESSep 24, 2025

Details

NPI
1174329403
Entity type
Individual (NPI-1)
Name
Stacyrae Viason Agusto
Sex
Female
Sole proprietor
No
Enumeration date
Feb 19, 2025
Certification date
Sep 24, 2025
Last updated
Sep 24, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner95034047CAYes

Practice location

8501 Brimhall Rd Bldg 100
Bakersfield, CA 93312-2327

Phone 661-370-0777 · Fax 661-654-8366

Mailing address

8501 Brimhall Rd Bldg 100
Bakersfield, CA 93312-2327

Phone 661-370-0777 · Fax 661-654-8366

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