Healthcare Provider Details

I. General information

NPI: 1407163934
Provider Name (Legal Business Name): SARA ABDIJADID D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E BELLE TER
BAKERSFIELD CA
93307-3871
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-635-2950
  • Fax: 661-635-2983
Mailing address:
  • Phone: 661-326-2249
  • Fax: 661-862-7682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A12327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: