Healthcare Provider Details

I. General information

NPI: 1700496759
Provider Name (Legal Business Name): IVANNA JENIFERR JOSEPH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STOCKDALE HWY STE 200
BAKERSFIELD CA
93311-3615
US

IV. Provider business mailing address

PO BOX 20815
BAKERSFIELD CA
93390-0815
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-0500
  • Fax: 661-324-0600
Mailing address:
  • Phone: 661-324-0500
  • Fax: 661-324-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA205966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: