Healthcare Provider Details

I. General information

NPI: 1083192504
Provider Name (Legal Business Name): JOSE ARMANDO ALCANTAR MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 HIGHWAY 178
BAKERSFIELD CA
93306-9510
US

IV. Provider business mailing address

18200 HIGHWAY 178
BAKERSFIELD CA
93306-9510
US

V. Phone/Fax

Practice location:
  • Phone: 661-871-9697
  • Fax: 661-871-1270
Mailing address:
  • Phone: 661-871-9697
  • Fax: 661-871-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number94029371
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: