Basic Information
Provider Information
NPI: 1174913925
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHATIA
FirstName: GEETA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 2050 S BLOSSER RD
Address2:  
City: SANTA MARIA
State: CA
PostalCode: 934587310
CountryCode: US
TelephoneNumber: 8053618028
FaxNumber: 8053618097
Practice Location
Address1: 2801 SANTA MARIA WAY
Address2:  
City: SANTA MARIA
State: CA
PostalCode: 934552118
CountryCode: US
TelephoneNumber: 8059345400
FaxNumber: 8059389207
Other Information
ProviderEnumerationDate: 02/02/2015
LastUpdateDate: 10/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X758723CAN Nursing Service ProvidersRegistered Nurse 
363LP0808X95003752CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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