Healthcare Provider Details

I. General information

NPI: 1144646829
Provider Name (Legal Business Name): AERIE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 16TH ST
BAKERSFIELD CA
93301-3417
US

IV. Provider business mailing address

2535 16TH ST
BAKERSFIELD CA
93301-3417
US

V. Phone/Fax

Practice location:
  • Phone: 661-869-1074
  • Fax: 661-869-1075
Mailing address:
  • Phone: 661-869-1074
  • Fax: 661-869-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number39354
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ANA LAURA MAGANA
Title or Position: MANAGING DIRECTOR
Credential: MS
Phone: 661-369-2101