Healthcare Provider Details

I. General information

NPI: 1598554057
Provider Name (Legal Business Name): FERNANDO BOCANEGRA AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10417 MAIN ST
LAMONT CA
93241-1726
US

IV. Provider business mailing address

PO BOX 21810
BAKERSFIELD CA
93390-1810
US

V. Phone/Fax

Practice location:
  • Phone: 661-845-5100
  • Fax: 661-845-5106
Mailing address:
  • Phone: 661-635-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC22150
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT161697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: