Healthcare Provider Details

I. General information

NPI: 1003641341
Provider Name (Legal Business Name): LIZA GLENN YAP PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 WORKMAN ST
BAKERSFIELD CA
93307-6800
US

IV. Provider business mailing address

1500 HAGGIN OAKS BLVD
BAKERSFIELD CA
93311-1332
US

V. Phone/Fax

Practice location:
  • Phone: 661-335-7140
  • Fax:
Mailing address:
  • Phone: 661-735-3887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95031361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: