Healthcare Provider Details

I. General information

NPI: 1376356444
Provider Name (Legal Business Name): OLIVIA BUMBACA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 86
TEHACHAPI CA
93581-0086
US

IV. Provider business mailing address

PO BOX 86
TEHACHAPI CA
93581-0086
US

V. Phone/Fax

Practice location:
  • Phone: 661-727-3233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23206
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: