Healthcare Provider Details

I. General information

NPI: 1386776060
Provider Name (Legal Business Name): VERONICA CEDILLOS MSW ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3628 STOCKDALE HWY
BAKERSFIELD CA
93309-2153
US

IV. Provider business mailing address

PO BOX 1559 ANN LEE CLINICA SIERRA VISTA
BAKERSFIELD CA
93302-1559
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-1021
  • Fax: 661-397-8286
Mailing address:
  • Phone: 661-635-3050
  • Fax: 661-869-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW21178
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: