Provider Demographics
NPI:1942031703
Name:DIXON, ANNA MARTINA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARTINA
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARTINA
Other - Last Name:SLOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 STOCKDALE HWY # M10-150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1091
Mailing Address - Country:US
Mailing Address - Phone:310-435-9891
Mailing Address - Fax:
Practice Address - Street 1:3805 SAN DIMAS ST STE B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5725
Practice Address - Country:US
Practice Address - Phone:661-326-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031303363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine