Healthcare Provider Details

I. General information

NPI: 1578885349
Provider Name (Legal Business Name): XOCHITL AMALIA MIRANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: XOCHITL AMALIA RODRIGUEZ

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 TRINIDAD AVE
BAKERSFIELD CA
93313-5199
US

IV. Provider business mailing address

6210 TRINIDAD AVE
BAKERSFIELD CA
93313-5199
US

V. Phone/Fax

Practice location:
  • Phone: 661-703-2026
  • Fax:
Mailing address:
  • Phone: 661-703-2026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: