Healthcare Provider Details

I. General information

NPI: 1043656812
Provider Name (Legal Business Name): MARINOAK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 HEIGHT ST
BAKERSFIELD CA
93305-2840
US

IV. Provider business mailing address

540 W MONTE VISTA AVE
VACAVILLE CA
95688-3620
US

V. Phone/Fax

Practice location:
  • Phone: 661-872-2324
  • Fax: 661-871-4661
Mailing address:
  • Phone: 707-449-3400
  • Fax: 707-450-0954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. PREMA PHILIP THEKKEK
Title or Position: SECRETARY / VP
Credential: RN, NHA
Phone: 707-330-0000