Healthcare Provider Details

I. General information

NPI: 1447776497
Provider Name (Legal Business Name): DAVID CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N CHESTER AVE
BAKERSFIELD CA
93308-1770
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-5272
  • Fax: 661-868-1839
Mailing address:
  • Phone: 661-868-6601
  • Fax: 667-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: