Provider Demographics
NPI:1720144405
Name:PLACENTI, ANTOINETTE M (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:M
Last Name:PLACENTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 NILES ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5007
Mailing Address - Country:US
Mailing Address - Phone:661-327-5984
Mailing Address - Fax:661-327-2541
Practice Address - Street 1:2145 NILES ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5007
Practice Address - Country:US
Practice Address - Phone:661-327-5984
Practice Address - Fax:661-327-2541
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF5827363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMP0517586OtherDEA