Individual
CARLOS FOMBONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5121 STOCKDALE HWY, BAKERSFIELD, CA 93309-2656
(661) 868-5066
Mailing address
1000 MEADOWS ST, BAKERSFIELD, CA 93306-5834
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW125110
CA
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/15/2022
Last updated
12/09/2024
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