Provider Demographics
NPI:1336337799
Name:BJORNSTAD, NAOMI KAMIL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:KAMIL
Last Name:BJORNSTAD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:KAMIL
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5101 SILVER CROSSING ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4127
Mailing Address - Country:US
Mailing Address - Phone:323-422-1518
Mailing Address - Fax:
Practice Address - Street 1:13646 HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:LOST HILLS
Practice Address - State:CA
Practice Address - Zip Code:93249-9719
Practice Address - Country:US
Practice Address - Phone:661-797-6691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19334363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PA193340Medicare PIN