Healthcare Provider Details

I. General information

NPI: 1134574767
Provider Name (Legal Business Name): BAKERSFIELD BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 TRUXTUN AVE STE 360
BAKERSFIELD CA
93309-0679
US

IV. Provider business mailing address

23801 COYOTE CT
TEHACHAPI CA
93561-9213
US

V. Phone/Fax

Practice location:
  • Phone: 661-821-0659
  • Fax: 661-821-0796
Mailing address:
  • Phone: 661-821-0659
  • Fax: 661-821-0796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License NumberLM185
License Number StateCA

VIII. Authorized Official

Name: MS. JUSTINE O'CONNELL BACKHAUS
Title or Position: OWNER, CLINICAL DIRECTOR, MIDWIFE
Credential: LM,CPM,IBCLC
Phone: 661-557-0639