Provider Demographics
NPI:1275960882
Name:SISON, MICHAEL JOHN SALVANA (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL JOHN
Middle Name:SALVANA
Last Name:SISON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5117 PELICAN HILL DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3987
Mailing Address - Country:US
Mailing Address - Phone:661-444-0889
Mailing Address - Fax:
Practice Address - Street 1:5117 PELICAN HILL DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-3987
Practice Address - Country:US
Practice Address - Phone:661-444-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA740119163WC0200X
CARN740119163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine