Healthcare Provider Details

I. General information

NPI: 1053780411
Provider Name (Legal Business Name): MR. JOSE LEONARDO CONTRERAS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2553 OLD FARM RD
BAKERSFIELD CA
93312-3531
US

IV. Provider business mailing address

2553 OLD FARM RD
BAKERSFIELD CA
93312-3531
US

V. Phone/Fax

Practice location:
  • Phone: 661-588-6000
  • Fax:
Mailing address:
  • Phone: 661-588-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: