Healthcare Provider Details
I. General information
NPI: 1568184737
Provider Name (Legal Business Name): GIOVANNA MONTSERRATT MARTINEZ OKOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/14/2022
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 E TRUXTUN AVE STE B
BAKERSFIELD CA
93305-5660
US
IV. Provider business mailing address
300 E TRUXTUN AVE STE B
BAKERSFIELD CA
93305-5660
US
V. Phone/Fax
- Phone: 661-852-5659
- Fax:
- Phone: 661-852-5659
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: