Provider Demographics
NPI:1376175752
Name:SAN-GIL, DEBORAH KRISTY (MSN, FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH KRISTY
Middle Name:
Last Name:SAN-GIL
Suffix:
Gender:F
Credentials:MSN, FNP-BC, NP-C
Other - Prefix:
Other - First Name:DEBORAH KRISTY
Other - Middle Name:
Other - Last Name:SAN GIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, FNP-BC, NP-C
Mailing Address - Street 1:14000 CARDIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-8996
Mailing Address - Country:US
Mailing Address - Phone:650-753-9784
Mailing Address - Fax:
Practice Address - Street 1:14000 CARDIGAN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-8996
Practice Address - Country:US
Practice Address - Phone:650-753-9784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner