Healthcare Provider Details

I. General information

NPI: 1104955384
Provider Name (Legal Business Name): RAMONA ELIZONDO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAMONA HERNANDEZ M.S., CADC II, MFT-I

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 BAKER ST # 4
BAKERSFIELD CA
93305-4341
US

IV. Provider business mailing address

1015 BAKER ST # 4
BAKERSFIELD CA
93305-4341
US

V. Phone/Fax

Practice location:
  • Phone: 661-328-4283
  • Fax:
Mailing address:
  • Phone: 661-328-4283
  • Fax: 661-843-8619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA910000
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number93394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: