Healthcare Provider Details

I. General information

NPI: 1861277600
Provider Name (Legal Business Name): CONCETTA LOUISE AGUINS CPT-1
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5213 TIERRA ABIERTA DR
BAKERSFIELD CA
93307-8345
US

IV. Provider business mailing address

5213 TIERRA ABIERTA DR
BAKERSFIELD CA
93307-8345
US

V. Phone/Fax

Practice location:
  • Phone: 951-807-6604
  • Fax:
Mailing address:
  • Phone: 951-807-6604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT23653
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: