Basic Information
Provider Information
NPI: 1891005815
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARRIDO
FirstName: DAVID
MiddleName: HERNANDEZ
NamePrefix: MR.
NameSuffix:  
Credential: BA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1000
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933021000
CountryCode: US
TelephoneNumber: 6618686100
FaxNumber: 6618686150
Practice Location
Address1: 1401 L ST
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933014522
CountryCode: US
TelephoneNumber: 6618686100
FaxNumber: 6618686150
Other Information
ProviderEnumerationDate: 10/08/2010
LastUpdateDate: 02/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XG1012031249CAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
171M00000X  N Other Service ProvidersCase Manager/Care Coordinator 
101YA0400X7241CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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