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NPI Code Detail

MEDICARE: DOROTHY JEAN ANDERSON PSYCH TECH #30701

MEDICARE: DOROTHY JEAN ANDERSON PSYCH TECH #30701
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1167G00000XLicensed Psychiatric TechnicianPT30701CA

General Provider Information

NPI Number : 1831229368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY JEAN ANDERSON PSYCH TECH #30701
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1000
Country : US
Telephone Number : 661-291-7948
Fax Number : 661-291-7978
Provider Business Practice Location Address
First Line : 17695 INDUSTRIAL FARM RD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-9520
Country : US
Telephone Number : 661-291-7948
Fax Number : 661-291-7978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 09/22/2015

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Directions to “ DOROTHY JEAN ANDERSON PSYCH TECH #30701” Practice Location

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