Healthcare Provider Details

I. General information

NPI: 1609180835
Provider Name (Legal Business Name): ANGELA MARIE SCHULLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W COLUMBUS ST
BAKERSFIELD CA
93301-1263
US

IV. Provider business mailing address

8017 DENNIS CT UNIT B
BAKERSFIELD CA
93306-4956
US

V. Phone/Fax

Practice location:
  • Phone: 661-328-0245
  • Fax:
Mailing address:
  • Phone: 661-366-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: