Healthcare Provider Details

I. General information

NPI: 1336119684
Provider Name (Legal Business Name): RUDY B HERRERA DC, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 7TH ST
WASCO CA
93280-1820
US

IV. Provider business mailing address

5397 TRUXTUN AVE
BAKERSFIELD CA
93309-0641
US

V. Phone/Fax

Practice location:
  • Phone: 661-725-5500
  • Fax:
Mailing address:
  • Phone: 661-634-9900
  • Fax: 661-634-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC21359
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1212429
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: