Healthcare Provider Details

I. General information

NPI: 1306358577
Provider Name (Legal Business Name): MRS. ASHLEY MARIE PEREIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2017
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 TRUXTUN AVE. SUITE 200
BAKERSFIELD CA
93301
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 275
BAKERSFIELD CA
93309-2667
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: