Healthcare Provider Details

I. General information

NPI: 1972216489
Provider Name (Legal Business Name): ALEXIS C NIEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 CALIFORNIA AVE STE 250
BAKERSFIELD CA
93309-0732
US

IV. Provider business mailing address

18200 HIGHWAY 178
BAKERSFIELD CA
93306-9510
US

V. Phone/Fax

Practice location:
  • Phone: 661-258-3240
  • Fax: 855-568-2494
Mailing address:
  • Phone: 661-871-9697
  • Fax: 661-871-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: