MEDICARE: FRANCISCO ANDRES ARCHIBEQUE

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1891412722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCISCO ANDRES ARCHIBEQUE

Provider Business Mailing Address
First Line	:	PO BOX 1000
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93302-1000
Country	:	US
Telephone Number	:	661-868-6840
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 KENTUCKY ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-4230
Country	:	US
Telephone Number	:	661-868-6840
Fax Number	:

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

Provider Enumeration Date	:	10/21/2022
Last Update Date	:	10/21/2022

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