Healthcare Provider Details

I. General information

NPI: 1144465212
Provider Name (Legal Business Name): CATHY L ELDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EASTON DR SUITE 147
BAKERSFIELD CA
93309-9412
US

IV. Provider business mailing address

1400 EASTON DR SUITE 147
BAKERSFIELD CA
93309-9412
US

V. Phone/Fax

Practice location:
  • Phone: 661-631-1763
  • Fax: 661-397-8339
Mailing address:
  • Phone: 661-631-1763
  • Fax: 661-397-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 19273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: