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General NPI Number Information
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NPI Number | 1861048746
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Entity Type | Individual
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Provider Name | NANCY PUENTES
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 5121 STOCKDALE HWY STE 200
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2664
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Country | US
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Telephone | 661-473-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 LENNOX AVE APT 8
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7422
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Country | US
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Telephone | 909-434-7221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 92049
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License Number State | CA
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