Healthcare Provider Details

I. General information

NPI: 1124959135
Provider Name (Legal Business Name): MS. ALYSSA CHRISTINE CARBAJAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 VAQUERO AVE
BAKERSFIELD CA
93308-6431
US

IV. Provider business mailing address

7500 VAQUERO AVE
BAKERSFIELD CA
93308-6431
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-7336
  • Fax: 661-587-9413
Mailing address:
  • Phone: 661-589-7336
  • Fax: 661-587-9413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number34573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: