Healthcare Provider Details

I. General information

NPI: 1902318025
Provider Name (Legal Business Name): ROSANDA J ANDERSON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4509 FOXBORO AVE
BAKERSFIELD CA
93309-5812
US

IV. Provider business mailing address

4509 FOXBORO AVE
BAKERSFIELD CA
93309-5812
US

V. Phone/Fax

Practice location:
  • Phone: 661-472-4431
  • Fax: 800-691-9109
Mailing address:
  • Phone: 661-472-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: ROSANDA JENAY ANDERSON
Title or Position: CEO
Credential:
Phone: 661-472-4431