Healthcare Provider Details

I. General information

NPI: 1639646094
Provider Name (Legal Business Name): MRS. YVONNE POWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 GARNSEY LN
BAKERSFIELD CA
93309-1740
US

IV. Provider business mailing address

1530 E 19TH ST
BAKERSFIELD CA
93305-5406
US

V. Phone/Fax

Practice location:
  • Phone: 661-631-5310
  • Fax: 661-861-0023
Mailing address:
  • Phone: 661-496-3017
  • Fax: 661-631-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number376108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: