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NPI Code Detail

MEDICARE: PEBBLES LATRICE WEST

MEDICARE: PEBBLES LATRICE WEST
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
1175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1346932894
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEBBLES LATRICE WEST
Provider Business Mailing Address
First Line : 2525 N CHESTER AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-1770
Country : US
Telephone Number : 661-868-1754
Fax Number :
Provider Business Practice Location Address
First Line : 2525 N CHESTER AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-1770
Country : US
Telephone Number : 661-686-1754
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/05/2026

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Directions to “ PEBBLES LATRICE WEST ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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