Healthcare Provider Details

I. General information

NPI: 1821138074
Provider Name (Legal Business Name): AKIRA SUZUKI SR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N CHESTER AVE SUITE C
BAKERSFIELD CA
93308-1770
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-1835
  • Fax: 661-868-1714
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY11287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: