Healthcare Provider Details

I. General information

NPI: 1982322343
Provider Name (Legal Business Name): MARIA D MOTA-MCCONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/30/2022
Certification Date: 08/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 STOCKDALE HWY
BAKERSFIELD CA
93311-1022
US

IV. Provider business mailing address

9001 STOCKDALE HWY
BAKERSFIELD CA
93311-1022
US

V. Phone/Fax

Practice location:
  • Phone: 661-654-3960
  • Fax:
Mailing address:
  • Phone: 661-654-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: