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Organization
ST THERESE MEDICAL GROUP
Active
Organization
ST THERESE MEDICAL GROUP
Active
Other names
TRUXTUN PSYCHIATRIC MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY FERRIS (CLINIC ADMINISTRATOR)
(661) 215-7659
Entity
Organization
Contact information
Practice address
223 CHINA GRADE LOOP, BAKERSFIELD, CA 93308-1707
(661) 391-0316
(661) 391-0313
Mailing address
223 CHINA GRADE LOOP, BAKERSFIELD, CA 93308-1707
(661) 391-0316
(661) 391-0313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A34791
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A347910
—
CA
01
—
1760545974
NPI
CA
Enumeration date
10/07/2008
Last updated
10/07/2008
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