MEDICARE: PATRICIA BALDENEGRO

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	104100000X	Social Worker	ASW125936	CA
2	1041C0700X	Clinical Social Worker	ASW86084	CA

General Provider Information

NPI Number	:	1467581215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA BALDENEGRO

Provider Business Mailing Address
First Line	:	661 ROBERTS LN STE B
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93308-4723
Country	:	US
Telephone Number	:	661-393-5836
Fax Number	:

Provider Business Practice Location Address
First Line	:	661 ROBERTS LN STE B
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93308-4723
Country	:	US
Telephone Number	:	661-393-5836
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	11/08/2024

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Directions to “ PATRICIA BALDENEGRO ” Practice Location

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