Healthcare Provider Details

I. General information

NPI: 1104772839
Provider Name (Legal Business Name): SKYES THE LIMIT INSTITUTE OF WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 23RD ST
BAKERSFIELD CA
93301-2902
US

IV. Provider business mailing address

700 23RD ST
BAKERSFIELD CA
93301-2902
US

V. Phone/Fax

Practice location:
  • Phone: 661-374-4332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: RETINA SHAW
Title or Position: BUSINESS MANAGER
Credential:
Phone: 661-374-4348