MEDICARE: VANESSA P WATKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1013894575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA P WATKINS

Provider Business Mailing Address
First Line	:	5701 YOUNG ST STE 103
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-8897
Country	:	US
Telephone Number	:	661-863-2306
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 YOUNG ST STE 103
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-8897
Country	:	US
Telephone Number	:	661-569-4136
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/18/2025

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Directions to “ VANESSA P WATKINS ” Practice Location

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