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General NPI Number Information
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NPI Number | 1396452546
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Entity Type | Organization
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Legal Business Name | LIFESTYLE TELEPSYCHIATRY PC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 4900 CALIFORNIA AVE STE 210B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7080
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Country | US
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Telephone | 310-243-6470
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 CALIFORNIA AVE STE 210B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7080
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH POSPOS
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Credential | MD
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Telephone | 310-243-6470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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