Healthcare Provider Details

I. General information

NPI: 1437402815
Provider Name (Legal Business Name): OLGA ACEVEDO CADC-CAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TOWER WAY STE 150A
BAKERSFIELD CA
93309-1597
US

IV. Provider business mailing address

1001 TOWER WAY STE 150A
BAKERSFIELD CA
93309-1597
US

V. Phone/Fax

Practice location:
  • Phone: 661-634-9877
  • Fax: 661-864-0198
Mailing address:
  • Phone: 661-634-9877
  • Fax: 661-864-0198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberS0412311706
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC050090118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: