Healthcare Provider Details

I. General information

NPI: 1932027497
Provider Name (Legal Business Name): RAYNA MARIE VANMULLEM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FINN VANMULLEM

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 DUNSMUIR RD APT 15
BAKERSFIELD CA
93309-1787
US

IV. Provider business mailing address

5301 DUNSMUIR RD APT 15
BAKERSFIELD CA
93309-1787
US

V. Phone/Fax

Practice location:
  • Phone: 661-421-5189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberY1939807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: