Healthcare Provider Details
I. General information
NPI: 1073303855
Provider Name (Legal Business Name): GUIDED GROWTH THERAPY GROUP A PSYCHOLOGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1603 CALIFORNIA AVE STE 137
BAKERSFIELD CA
93304-1346
US
IV. Provider business mailing address
10900 ARTIST CT
BAKERSFIELD CA
93312-2879
US
V. Phone/Fax
- Phone: 661-404-4123
- Fax: 661-404-4123
- Phone: 661-404-4123
- Fax: 661-404-4123
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KIMBERLY
ANN
COBBS
Title or Position: OFFICE MANAGER
Credential:
Phone: 661-404-4123