Healthcare Provider Details

I. General information

NPI: 1689675415
Provider Name (Legal Business Name): AMERICAN BAPTIST HOME OF THE WEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 NEW STINE RD
BAKERSFIELD CA
93309-3530
US

IV. Provider business mailing address

1900 HUNTINGTON DR
DUARTE CA
91010-2694
US

V. Phone/Fax

Practice location:
  • Phone: 661-834-0620
  • Fax: 661-832-2357
Mailing address:
  • Phone: 818-247-0420
  • Fax: 949-528-2434

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: GWEN VANGELISTO
Title or Position: DIRECTOR OF ACCOUNTS RECEIVABLE
Credential:
Phone: 949-463-0893