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Individual

JORDAN BRE'ANN LITTLEBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
708 WORKMAN ST, BAKERSFIELD, CA 93307
(661) 335-7100
Mailing address
3433 W SHAW AVE STE 103, FRESNO, CA 93711-3229
(559) 558-4051

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42054
CA
167G00000X
Licensed Psychiatric Technician
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1568219855
TELECARE CORPORATION
CA
Enumeration date
05/01/2024
Last updated
12/09/2024
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