Healthcare Provider Details

I. General information

NPI: 1891318465
Provider Name (Legal Business Name): CHRISTIAN O'BRIAN MUNOZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 N SHAFTER AVE
SHAFTER CA
93263-1967
US

IV. Provider business mailing address

1300 17TH ST
BAKERSFIELD CA
93301-4504
US

V. Phone/Fax

Practice location:
  • Phone: 661-746-8600
  • Fax:
Mailing address:
  • Phone: 661-636-4025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberASW87645
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: