Basic Information
Provider Information
NPI: 1609387166
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEL PILAR
FirstName: ANNALYN
MiddleName: DE JESUS
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 40 S MAIN ST STE 1300
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381035513
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Practice Location
Address1: 4900 CALIFORNIA AVE
Address2: TOWER B, STE 210B
City: BAKERSFIELD
State: CA
PostalCode: 933097080
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2017
LastUpdateDate: 09/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialMiddleName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95007753CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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