Healthcare Provider Details

I. General information

NPI: 1972339075
Provider Name (Legal Business Name): LILLI J PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 4TH ST
BAKERSFIELD CA
93304-2217
US

IV. Provider business mailing address

530 4TH ST
BAKERSFIELD CA
93304-2217
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-1113
  • Fax:
Mailing address:
  • Phone: 661-325-1113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: