Healthcare Provider Details

I. General information

NPI: 1134011430
Provider Name (Legal Business Name): CHENG LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2025
Last Update Date: 07/19/2025
Certification Date: 07/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 KIRKCALDY DR
BAKERSFIELD CA
93306-5542
US

IV. Provider business mailing address

4930 GOSFORD RD APT 180
BAKERSFIELD CA
93313-6106
US

V. Phone/Fax

Practice location:
  • Phone: 661-688-7000
  • Fax:
Mailing address:
  • Phone: 619-416-9564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number29322
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: