Healthcare Provider Details

I. General information

NPI: 1962315929
Provider Name (Legal Business Name): SHAWN D WEEMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 SOUTHGATE DR
BAKERSFIELD CA
93304-5146
US

IV. Provider business mailing address

921 BAKER ST
BAKERSFIELD CA
93305-4317
US

V. Phone/Fax

Practice location:
  • Phone: 661-862-3730
  • Fax:
Mailing address:
  • Phone: 661-862-3730
  • Fax:

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: