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General NPI Number Information
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NPI Number | 1326516899
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Entity Type | Organization
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Legal Business Name | SOCIAL STAMINA BEHAVIOR CONSULT SERVICES
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 841 MOHAWK ST STE 250
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1547
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Country | US
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Telephone | 661-432-6115
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Fax | 661-424-7005
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Provider Business Mailing Address
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Address Line | 841 MOHAWK ST STE 250
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1547
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Country | US
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Telephone | 661-432-6115
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Fax | 661-424-7005
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Authorized Official
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Title or Position | LICENSED EDUCATIONAL PSYCHOLOGIST
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Name | GINA GORDON-LOPEZ
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Credential | LEP2972
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Telephone | 661-432-6115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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