MEDICARE: MRS. SARAH E ELVIRA

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	1041C0700X	Clinical Social Worker	LCSW123312	CA

General Provider Information

NPI Number	:	1841328143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH E ELVIRA

Provider Business Mailing Address
First Line	:	PO BOX 1000
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93302-1000
Country	:	US
Telephone Number	:	661-868-6601
Fax Number	:	661-868-6752

Provider Business Practice Location Address
First Line	:	2621 OSWELL ST
Second Line	:	STE 119
City	:	BAKERSFIELD
State	:	CA
Zip	:	93306-3172
Country	:	US
Telephone Number	:	661-868-6750
Fax Number	:	661-868-6752

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	06/25/2024

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