Healthcare Provider Details

I. General information

NPI: 1558098079
Provider Name (Legal Business Name): ANASTASIA RIVERA MENTAL WELLNESS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 COLLINGWOOD DR
BAKERSFIELD CA
93311-8757
US

IV. Provider business mailing address

3727 COLLINGWOOD DR
BAKERSFIELD CA
93311-8757
US

V. Phone/Fax

Practice location:
  • Phone: 661-808-3513
  • Fax:
Mailing address:
  • Phone: 661-808-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANASTASIA RIVERA
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 661-808-3513