Healthcare Provider Details

I. General information

NPI: 1174807713
Provider Name (Legal Business Name): MRS. MARIA AZUCENA CANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S UNION AVE STE. 100
BAKERSFIELD CA
93307-4179
US

IV. Provider business mailing address

1104 BURGUNDY CT
MC FARLAND CA
93250-1655
US

V. Phone/Fax

Practice location:
  • Phone: 661-397-8775
  • Fax: 661-397-8286
Mailing address:
  • Phone: 661-586-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: