Healthcare Provider Details

I. General information

NPI: 1710527197
Provider Name (Legal Business Name): FELICA JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5417 PACER VALLEY CT
BAKERSFIELD CA
93313-4304
US

IV. Provider business mailing address

5417 PACER VALLEY CT
BAKERSFIELD CA
93313-4304
US

V. Phone/Fax

Practice location:
  • Phone: 661-412-7611
  • Fax:
Mailing address:
  • Phone: 661-412-7611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: