Healthcare Provider Details

I. General information

NPI: 1639603442
Provider Name (Legal Business Name): DANIA KARINA RIVERA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SANFORD DR
BAKERSFIELD CA
93308-3150
US

IV. Provider business mailing address

1300 17TH ST
BAKERSFIELD CA
93301-4504
US

V. Phone/Fax

Practice location:
  • Phone: 661-392-0878
  • Fax:
Mailing address:
  • Phone: 661-852-5660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW116378
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: