Healthcare Provider Details

I. General information

NPI: 1104644012
Provider Name (Legal Business Name): TRIFECTA MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/02/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 MEANY AVE STE 101
BAKERSFIELD CA
93308-5199
US

IV. Provider business mailing address

7702 MEANY AVE STE 101
BAKERSFIELD CA
93308-5199
US

V. Phone/Fax

Practice location:
  • Phone: 661-843-7830
  • Fax: 559-223-9907
Mailing address:
  • Phone: 661-843-7830
  • Fax: 559-223-9907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VALERIE CIVELLI
Title or Position: CEO
Credential: MD
Phone: 850-206-9553