Healthcare Provider Details

I. General information

NPI: 1154226132
Provider Name (Legal Business Name): BROOKLYN MACI BISHOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 STOCKDALE HWY STE 340
BAKERSFIELD CA
93311-1015
US

IV. Provider business mailing address

9700 STOCKDALE HWY STE 340
BAKERSFIELD CA
93311-3617
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-1577
  • Fax:
Mailing address:
  • Phone: 661-326-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: