Provider Demographics
NPI:1336378702
Name:BAKHDA, KRISTIN ANNE (CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANNE
Last Name:BAKHDA
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ANNE
Other - Last Name:BERNDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM, WHNP
Mailing Address - Street 1:530 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4204
Mailing Address - Country:US
Mailing Address - Phone:817-300-5804
Mailing Address - Fax:
Practice Address - Street 1:530 DRY CREEK RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4204
Practice Address - Country:US
Practice Address - Phone:817-300-5804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA705243363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health