Healthcare Provider Details

I. General information

NPI: 1114641420
Provider Name (Legal Business Name): LATOYA CAPRI LITTLEJOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY
BAKERSFIELD CA
93309-2656
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 275
BAKERSFIELD CA
93309-2667
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-5000
  • Fax:
Mailing address:
  • Phone: 661-868-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: