Healthcare Provider Details

I. General information

NPI: 1265031645
Provider Name (Legal Business Name): FHERNALYN BERMUDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 10/18/2020
Certification Date: 10/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 COLONY ST
BAKERSFIELD CA
93307-6538
US

IV. Provider business mailing address

5600 PARK RIDGE CT
BAKERSFIELD CA
93313-5669
US

V. Phone/Fax

Practice location:
  • Phone: 661-832-7997
  • Fax:
Mailing address:
  • Phone: 661-472-8141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number85023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: