Healthcare Provider Details

I. General information

NPI: 1104733252
Provider Name (Legal Business Name): AFFINITY GROUP THERAPY CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 16TH ST STE H
BAKERSFIELD CA
93301-5180
US

IV. Provider business mailing address

13817 ROMERO AVE
BAKERSFIELD CA
93314-9339
US

V. Phone/Fax

Practice location:
  • Phone: 661-374-8577
  • Fax:
Mailing address:
  • Phone: 661-374-8577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JACQUELINE SMITH
Title or Position: CEO
Credential: LMFT
Phone: 323-707-4897