Healthcare Provider Details

I. General information

NPI: 1477261634
Provider Name (Legal Business Name): MS. CECEILIA YZAGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 ZEUS CT
BAKERSFIELD CA
93308-6867
US

IV. Provider business mailing address

2201 ZEUS CT
BAKERSFIELD CA
93308-6867
US

V. Phone/Fax

Practice location:
  • Phone: 888-831-7977
  • Fax: 888-831-0909
Mailing address:
  • Phone: 888-831-7977
  • Fax: 888-831-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number56242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: