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General NPI Number Information
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NPI Number | 1134574767
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Entity Type | Organization
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Legal Business Name | BAKERSFIELD BIRTH CENTER
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 6001 TRUXTUN AVE STE 360
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-821-0659
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Fax | 661-821-0796
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Provider Business Mailing Address
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Address Line | 23801 COYOTE CT
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City | TEHACHAPI
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State | CA
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Zip | 93561-9213
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Country | US
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Telephone | 661-821-0659
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Fax | 661-821-0796
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR, MIDWIFE
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Name | MS. JUSTINE O'CONNELL BACKHAUS
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Credential | LM,CPM,IBCLC
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Telephone | 661-557-0639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number | LM185
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License Number State | CA
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