Healthcare Provider Details

I. General information

NPI: 1205741345
Provider Name (Legal Business Name): ELIZABETH CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH SANCHEZ

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S FAIRFAX RD
BAKERSFIELD CA
93307-3151
US

IV. Provider business mailing address

1500 S FAIRFAX RD
BAKERSFIELD CA
93307-3151
US

V. Phone/Fax

Practice location:
  • Phone: 661-363-7684
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number220190418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: