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General NPI Number Information
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NPI Number | 1225293202
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Entity Type | Organization
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Legal Business Name | PINE MEADOW COUNSELING INC
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 7201 SCHIRRA CT STE E
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City | BAKERSFIELD
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State | CA
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Zip | 93313-2051
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Country | US
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Telephone | 661-834-7564
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Fax | 661-831-8882
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Provider Business Mailing Address
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Address Line | 7850 WHITE LN # E249
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7698
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Country | US
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Telephone | 661-834-7564
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Fax | 661-831-8882
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Authorized Official
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Title or Position | COO
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Name | RENEE MICHELE ORTIZ-CROUCH
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Credential | LMFT
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Telephone | 661-834-7564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | CA
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