Healthcare Provider Details

I. General information

NPI: 1306153671
Provider Name (Legal Business Name): SHERRILL ANNE ELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 34TH ST
BAKERSFIELD CA
93301-2283
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-410-9772
  • Fax: 661-868-7877
Mailing address:
  • Phone: 661-868-6100
  • Fax: 661-868-6133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW73523
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number78718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: